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Bunions

The common bunion is a localized area of enlargement of the inner portion of the joint at the base of the big toe. The enlargement actually represents additional bone formation, often in combination with a misalignment of the big toe. The normal position of the big toe (straight forward) becomes outward-directed toward the smaller toes. The enlarged joint at the base of the big toe (the first metatarsophalangeal joint) can become inflamed with redness, tenderness, and pain. A small fluid-filled sac (bursa) adjacent to the joint can also become inflamed (bursitis) leading to additional swelling, redness, and pain

Symptoms

Bunions may or may not cause symptoms. A frequent symptom is pain in the involved area when walking or wearing shoes that is relieved by resting. A bunion causes enlargement of the base of the big toe and is usually associated with positioning of the big toe toward the smaller toes. This leads to intermittent or chronic pain at the base of the big toe.
Bunions that cause marked pain are often associated with swelling of the soft tissues, redness, and local tenderness.

Treatment

For those whose bunions cause persisting pain, a surgical operation is considered. Surgical procedures can correct deformity and relieve pain leading to improved function. These procedures typically involve removing the bony growth of the bunion while realigning the big toe. Surgery is often, but not always, successful, and failure to relieve pain can result from the big toe moving back to its deviated position before the operation. Proper footwear and activity restrictions can reduce the chances of surgical failure.

Flatfeet

You have flatfeet when the arch on the inside of your feet is flattened, allowing your entire foot to touch the floor when you stand up.
A common and usually painless condition, flatfeet may occur when the arches don’t develop during childhood. In other cases, flatfeet may be caused by an injury or from the simple wear-and-tear stresses of age.
Flatfeet can sometimes cause problems in your ankles and knees because the condition can force your ankles to turn inward and this throws off the alignment of your legs. If you aren’t experiencing any pain, no treatment is usually necessary for flatfeet.

Symptoms

Although many people have no signs or symptoms associated with flatfeet, some people experience:

• Foot pain, particularly in the heel or arch area
• Difficulty standing on tiptoe
• Swelling along the inside of the ankle

Treatment

Conservative treatment is effective in the vast majority of flat foot cases, and consists of treatments such as orthotics, shoe recommendations, anti-inflammatory measures and special strengthening exercises. Surgery is rarely required, and is reserved only for the most severe types of flat foot that do not respond to conservative therapy.

Plantar Fasciitis

Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain. It involves pain and inflammation of a thick band of tissue, called the plantar fascia, which runs across the bottom of your foot — connecting your heel bone to your toes.
Plantar fasciitis causes stabbing pain that usually occurs with your very first steps in the morning. Once your foot limbers up, the pain of plantar fasciitis normally decreases, but it may return after long periods of standing or after getting up from a seated position.

Symptoms

Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. You may have less stiffness and pain after you take a few steps. But your foot may hurt more as the day goes on. It may hurt the most when you climb stairs or after you stand for a long time.

Treatment

Conservative treatment is almost always successful, given enough time. Treatment can last from several months to 2 years before symptoms get better. Most patients will be better in 9 months.
Initial treatment usually consists of:

• Anti-inflammatory medications
• Heel stretching exercises
• Night splints
• Shoe inserts

If these fail, putting the affected foot in a short leg cast (a cast up to but not above the knee) for 3-6 weeks is very often successful in reducing pain and inflammation. Alternatively, a cast boot (which looks like a ski boot) may be used. It is still worn full time, but can be removed for bathing.

Some physicians will offer steroid injections, which can provide lasting relief in many people. However, this injection is very painful and not for everyone.
In a few patients, non-surgical treatment fails and surgery to release the tight, inflamed fascia becomes necessary.

Tendonitis

Tendonitis is a form of an inflammation of a tendon. Specifically, the term is used for tendon injuries that involve larger-scale acute injuries accompanied by inflammation. The term tendonitis refers to the areas which are more commonly involved, Achilles tendon and the Patellar tendon. Tendonitis affects all joints of the body, but it is more common in the upper and lower limbs. Although, the hips and torso may endure tendonitis, it is far less common.

Symptoms

The symptoms of tendonitis can vary from aches or pains to local stiffness of joints. In severe cases, a burning sensation may surround the whole joint around the inflamed tendon. In most cases, swelling will happen along with heat and redness. In certain instances, visible knots may surround the joint. The pain is usually worse during and immediately following activity. Usually the tendon and joint become stiffer the following day. Stiffness of the joint and swelling of the inflamed area are the most noticeable symptoms.

Treatment

There are a number of different treatments for tendonitis. The most conservative approach is the RICE producure, Rest, Ice, Compress, and Elevate. Resting ensures that you do not further insure your tendon. Ice is an effective way of alleviating pain, stimulating blood flow, and reducing swelling. Compression and elevation work in the same manner as ice. They limit the excessive inflammation. The initial recover from tendonitis usually takes a couple day and a full recover usually occurs within 4 to 6 weeks.

Warts

Warts are small, usually painless growths on the skin caused by a virus. They are generally harmless. However, warts can be disfiguring and embarrassing, and occasionally they itch or hurt (particularly on the feet).

Symptoms

• Abnormally dark or light skin surrounding the lesion
• Numerous small, smooth, flat (pinhead sized) lesions on forehead, cheeks, arms, or legs
• Rough growths around or under fingernails or toenails
• Rough, round, or oval lesions on soles of feet — flat to slightly raised — painful to pressure
• Small, hard, flat or raised skin lesion or lump

Treatment

Over-the-counter medications can remove warts. These are applied to the wart every day for several weeks. Stronger (prescription) medications may be required for removal of persistent warts. Surgical removal or removal by freezing (cryotherapy), burning (electrocautery), or laser treatment may be needed.

Hammertoe

A hammer toe is a deformity of the proximal interphalangeal joint of the second, third, or fourth toe causing it to be permanently bent, resembling a hammer. Mallet toe is a similar condition affecting the distal interphalangeal joint.

Symptoms

Hammer toe most frequently results from wearing poorly fit shoes that can force the toe into a bent position, such as excessively high heels or shoes that are too short or narrow for the foot. Having the toes bent for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity. This is often found in conjunction with bunions or other foot problems. It can also be caused by muscle, nerve, or joint damage resulting from conditions such as osteoarthritis, rheumatoid arthritis, stroke, Charcot-Marie-Tooth disease or diabetes

Treatment

In many cases, conservative treatment consisting of physical therapy and new shoes with soft, spacious toe boxes is enough to resolve the condition, while in more severe or longstanding cases orthopedic surgery may be necessary to correct the deformity. The patient’s doctor may also prescribe some toe exercises that can be done at home to stretch and strengthen the muscles. For example, the individual can gently stretch the toes manually, or use the toes to pick things up off the floor. While watching television or reading, one can put a towel flat under the feet and use the toes to crumple it. The doctor can also prescribe a brace that pushes down on the toes to force them to stretch out their muscles.

Ankle Pain

Ankle sprains are the most common type of ankle pain that people experience. Sprains are injuries to the ligaments of the ankle, which causes them to tear as a result of the sudden stretching. Ankle sprains can happen either on the inner or outer portion of the ankle joint.

Symptoms

When you sprain your ankle, the first symptom you notice is the immediate pain. This pain can be initially severe and you may notice a “popping” sensation. There is usually immediate swelling of the injured area. This is a result of the injured blood cells leaking fluid into the local tissue. In most cases, the pain and swelling is so much that you are unable to put constant pressure on your ankle.

Treatment

The most common sprain people endure is an acute ankle sprain. Acute ankle sprains can be easily treated without the need of hospitalization. When you endure an acute ankle sprain, you should initially treat the area with ice to reduce the initial swelling. After you have tended to the swelling, you should limit the amount of walking and weight you put on the injured ankle. In more severe cases, you may need to elevate the ankle to further reduce swelling and require the use of crutches until you fully recover.

Heel Pain

Pain suffered in the heel can be attributed to a number of factors. Abnormalities of the skin, nerves, bones, blood vessels, and soft tissues of the heel can all result in pain. Due to the amount of constant pressure we put on our heels throughout the day, we are at a high risk of injuring our heels. Some of the most common causes of heel pain are blisters and corns. Plantar Fasciitis, or inflammation of the tissue in the sole of the foot, is another condition commonly associated with heel pain.

Symptoms

There are a number of different symptoms associated with heel pain and the different factors that cause it. The most common symptom is pain associated with putting constant pressure on the injured heel. This pain usually affects the bottom of the heel. There also may be swelling around the heel. In the case of blisters and corns, you will notice abnormal growths on the bottom of the heel. There are a number of different symptoms and a number of different causes. For best diagnosis, consult with your doctor.

Treatment

For all sources of heel pain, the best treatment is limiting the amount of pressure you put on your heel. This reduces the stress you put on your heel and it allows for swelling to subside. For common causes of heel pain, such as blisters and corns, see for pharmacist for over-the-counter medication. In all cases, it may be beneficial to elevate your foot to reduce the amount of blood flow to the problematic area. In severe cases, consult with your physician about further treatment.