Common Foot Problems and Its Management

Introduction

The foot is a complex part of the human body made of 26 bones connected by muscles, tendons, joints, and ligaments. It is a part that is susceptible to many stresses. Foot problems can result in pain, swelling, or injury and limit mobility and movement.

Foot pain mostly occurs due to improper foot function. Improperly fitting shoes can worsen foot problems or even result in foot issues. Different types of foot problems can affect the toes, tendons, nerves, ligaments, joints, and heels of the foot.

What Is Morton's Neuroma?

Morton's Neuroma is characterized by the thickening of tissues around a nerve that leads to the toes. It is a compressive neuropathy (nerve damage) of the interdigital nerve of the forefoot region. The commonest location is between the third and fourth metatarsal heads. The exact cause of Morton's neuroma is unknown. The condition is more prevalent in middle-aged females and is five times more common in females than males.

The symptoms are:

• Sharp or burning pain concerning the ball of the foot.

• Patients usually complain of the sensation of walking on marble or stone.

• Some complain of numbness between the toes.

• Non-surgical management options include footwear changes, orthotics, and injections. Surgery is indicated in cases where non-surgical options fail.

What Are Bunions?

Bunions are painful bony projections at the base of the big toe joint that develop when the big toes lean towards the remaining toes. It is more prevalent in women. Pain can occur in the bony projection due to shoe irritation and the alteration of mechanical forces on the ball of the feet. Individuals born with an abnormal bone alignment in their foot have a higher chance of developing a bunion. The condition can run in families. The symptoms are mostly seen at later stages, while the disease may be asymptomatic in some.

Treatment options depend on several factors, like the severity of symptoms, the type of deformity, and other medical conditions like diabetes, rheumatoid arthritis, etc.

Conservative or non-surgical treatment options mainly focus on relieving symptoms and slowing disease progression. But these cannot correct the bone misalignment, for which surgical treatment is needed.

What Is an Ingrown Toenail?

The condition in which the toenail grows into the skin around it is an ingrowing toenail. It is also referred to as onychocryptosis. The skin may get damaged, resulting in pain and infection. It mostly affects the big toenails. The condition is most prevalent in young males and accounts for 20 percent of foot issues in primary care. Footwear, improper nail trimming, foot hygiene, genetic predisposition, repetitive trauma, etc., can contribute to the condition.

Ingrown toenails, if untreated, progress, and the toes become more painful, affecting the individual’s functional ability.

Treatment is indicated in the following cases:

• Secondary infection.

• Pain.

• Recurrent paronychia (infection of the skin around the toenails)

• Onychogryphosis (a yellow-brown opaque thickening of the nail plate with increased curvature)

• Non-surgical treatment options are preferred in cases of mild to moderate ingrown toenails. In moderate to severe cases of ingrown toenails, surgical treatment is indicated.

What Are Corns and Calluses?

Calluses are areas of thickened or hardened skin on the foot that develop due to friction or pressure. Corns are callus growths that develop on the top of the toes due to irritation. The symptoms include pain on pressure in the area, white rubbery skin bumps, etc.

Treatment options include:

• Application of pads in the affected region.

• Footwear change (choosing shoes that do not produce friction).

• Shaving layers of dead skin.

• surgery.

What Is a Heel Spur?

Heel spurs are bone growths in the heel region. The most common location is on the underside of the heel bone, at the region of attachment of the plantar fascia. The plantar fascia gets overstretched due to obesity, ill-fitting shoes, running, etc. In response to the stress, extra bone develops, resulting in heel spurs.

The treatment options include:

• Cold packs.

• Anti-inflammatory medications.

• Appropriate footwear.

• Shoe inserts.

• Corticosteroid shots.

• Surgery.

What Are Foot Fractures?

The feet consist of 26 bones, and there is a chance that any of these can fracture. These foot fractures usually do not require surgical correction and heal independently. The fracture site usually becomes inflamed and painful.

The treatment depends on the fracture site:

• Toe Fracture - Toe fractures usually occur in heels with a supportive, hard shoe.

• Ankle Joint Fractures - Ankle joint fractures usually require immediate medical attention and may require a splint, cast, or surgical correction.

• Sesamoid Bone Fracture- Sesamoid bones are two round, tiny bones at the end of the metatarsal bone of the first toe. Such fractures usually require only paddled soles, but in some cases, surgery is needed.

• Metatarsal Bone Fracture - Metatarsal bones are located in the middle of the foot, and such fractures are mostly heeled using stiff-soled shoes.

What Are Plantar Fasciitis and Achilles Tendonitis?

Plantar fascia is the connective tissue band that runs from the heel bone to the base of the toes in the plantar surface of the foot. The inflammation of plantar fascia is called plantar fasciitis. Plantar fasciitis occurs due to overuse injury of the plantar foot surface and is characterized by heel pain. The condition is commonly seen in young runners and middle-aged individuals who are overweight.

Treatment options include:

• Ice packs.

• Rest.

• Stretching exercises.

• NSAIDs (non-steroidal anti-inflammatory drugs).

• Injections or surgery.

• Achilles tendonitis occurs due to overuse of the Achilles tendon (which connects the heel bone and calf muscles) and calf muscles, resulting in tendon inflammation.

• Treatment options include:

• Rest.

• Stretching exercises.

• NSAIDs (non-steroidal anti-inflammatory drugs)

• Massage.

• Surgery.

What Are Hammertoes?

Hammertoes are conditions in which the toes curl downward as a result of the middle joint of the toe pocks out. Ill-fitting shoes can worsen the condition, and corn may develop at the site. Treatment options include:

• Application of pads in the affected region.

• Footwear change.

• Surgery.

How Does Diabetes Result in Foot Issues?

Those with diabetes are at greater risk of developing foot problems. The increased risk is due to:

• Poor wound healing is due to impaired circulation.

• Due to nerve damage, the affected people lose sensation in their feet.

• Therefore, the affected person should regularly check their feet for blisters, cuts, bruises, or injuries.

What Is an Ankle Sprain?

An injury to the ankle ligaments results in an ankle sprain. It can occur when the ankle twists, turns, or rolls beyond its range of motion. The symptoms depend on the severity of the ligament injury and include pain, swelling, or bruising.

Treatment options include:

• Rest.

• Keeping the foot elevated.

• Ice pack application.

• Over-the-counter medications.

• Physical therapy.

• Exercises

• Surgery.

Conclusion

Most foot problems can be prevented or managed by non-surgical options like medications, appropriate footwear, orthotics, proper rest, exercises, physical therapy, cold packs, etc., but only in cases of severe foot issues requiring correction of bone alignment or in cases where symptoms are severe and persistent surgical corrections are needed.