Common Foot Problems

Arthritis causes inflammation, stiffness, and pain around the joints. Both osteoarthritis  and rheumatoid arthritis are common in the ankle and foot – especially at the metatarsophalangeal (MTP) joint of the big toe, where the toe bone connects to the rest of the foot.

The MTP joint is large and sustains a lot of pressure when walking, making it particularly susceptible to wear-and-tear issues like arthritis. Arthritis affecting the MTP joint of the big toe is also sometimes called hallux rigidus.

This term means “stiff big toe” and it occurs when the joint at the base of the big toe wears down and makes movement difficult. Hallux rigidus is a progressive condition, and over time, the toe may become very stiff. It is the most common type of arthritis affecting the foot.

Symptomatic relief can often be achieved through conservative therapies such as anti-inflammatory medications (including corticosteroid injections) to reduce pain and swelling, custom orthotics to relieve pressure and improve foot function, and hot and cold therapy. In the case of severe degeneration in the ankle from arthritis, your podiatrist may recommend an ankle replacement.

Gout can also cause pain and inflammation around the big toe joint, brought on by a buildup of uric acid. However, gout symptoms in the feet tend to be sudden and severe – as opposed to arthritis symptoms in the feet, which tend to develop slowly over time.

This extremely common and highly contagious problem is a type of fungal infection.

Athlete’s foot, or tinea pedis, can cause a scaly rash that can burn, sting, and itch – and may lead to blisters or dry, cracked skin on your feet. It usually appears between the toes and on the soles of the feet and can spread to the toenails. It occurs after direct exposure to fungi (including yeast), typically in a moist environment like a locker room, public shower, or swimming pool.

Prescription antifungal medication is needed to clear the infection, and it can take months to completely resolve. The foot doctors at The Podiatry Group of South Texas also offer fungal nail laser treatment in cases where the infection has spread to the toenails.

Hammertoe and Mallet Toe: These toe deformities cause one or more toes to bend downward due to a contraction in the middle joint of the toe (hammertoe) or the joint at the end of the toe (mallet toe). The conditions typically affect the second, third, or fourth toes and may be accompanied by pain and stiffness of the affected toe. Corns and calluses may develop.

Hammertoe and mallet toe can occur due to genetics, injury, arthritis, imbalance in the toe muscles, and ill-fitting shoes. Wearing roomy shoes can help relieve pain. If you can still bend your toes, your podiatrist might recommend orthotics to reposition the toes and exercises to help stretch the toe muscles. Surgery may be required if the toes become stuck in the bent position.

Claw toe (Claw Foot): This toe deformity causes the joint at the base of the toe to bend upward and the toes to curl downward like a claw. It typically affects the four smaller toes at the same time and affects women far more frequently than men.

While claw toe can occur due to structural changes in the nerves, muscles, or tendons that bend the toes, it often results from wearing tight, ill-fitting shoes such as those with a pointed toe and high heels.

It is important to treat claw toe because the condition will worsen over time and may result in permanent disfigurement. If caught early, custom orthotics or a splint may be used to treat claw toe. Later interventions include surgery.

Turf toe is a sprain of the ligament at the joint of the big toe. It became a common injury among football players after less shock-absorbent artificial turf was introduced on the playing field – hence the name, “turf toe.” It occurs when the big toe overextends, spraining or tearing tissue at the metatarsophalangeal (MTP) joint.

Most cases of turf toe can be treated nonsurgically with some combination of RICE (rest, icing, compression, elevation), painkillers and anti-inflammatory medications, custom orthotics, immobilization, and physical therapy – depending on the extent of the injury and intensity of symptoms. In extreme cases, surgery may be necessary to repair soft tissue in the area, reposition bones, and fuse or replace the MTP joint itself.

Morton’s neuroma  causes burning pain and numbness between the third and fourth toe and ball of the foot that may radiate into the toes. You may feel as if you are walking on a marble. The condition occurs when tissue surrounding the nerve between the third and fourth toes thickens and compresses a nerve.

Morton’s neuroma is most common among middle-aged women and runners. It results from prolonged pressure on the ball of the feet due to high heels, sports injuries, and gait abnormalities. Custom orthotics and anti-inflammatories (including corticosteroid injections) may relieve symptoms. In some cases, surgery to relieve compression on the nerve can help.

Plantar warts tend to develop on weight-bearing areas of the foot, such as the heel or ball of the foot. They are subject to incredible pressure in these locations when walking, running, or even just standing. Over time, this can cause the warts to grow inward, into the foot. Plantar warts are highly contagious and can be very painful.

These warts are transmitted by human papillomavirus (HPV) infection. They may eventually go away on their own without treatment. If they do not, however, it’s best to let a podiatrist remove a plantar wart instead of trying over-the-counter remedies, especially for those with diabetes or poor circulation.

Also known as posterior tibial neuralgia, tarsal tunnel syndrome (TTS) involves pain felt in the foot, usually either on the sole or at the inside ankle due to compression of the tibial nerve. The tibial nerve branches off the sciatic nerve, traveling down the lower leg and into the ankle via the tarsal tunnel. This nerve is what allows sensation and movement in parts of the foot.

Much like the more well-known carpal tunnel syndrome, pain symptoms occur when the tibial nerve is compressed as it travels through the tarsal tunnel. It can become compressed due to a variety of issues, such as inflammation of a nearby tendon or blood vessel, arthritis or diabetes, abnormal growths such as a bone spur, or an arch that is too high or has fallen resulting in flatfoot.

TTS symptoms include burning pain, numbness, and a pins-and-needles sensation.

Conditions such as plantar fasciitis and posterior tibial tendonitis can cause symptoms similar to TTS.

Nerve conduction velocity (NCV) tests and electromyograms (EMGs) are typically used to diagnose tarsal tunnel syndrome. Treatment will depend on the cause of the nerve compression.

When tendons – the strong, fibrous tissue connecting muscle to bone – become irritated and inflamed, it is called tendonitis. This can occur anywhere in the body, usually as a result of repetitive strain. Tendonitis causes pain that can range from minor to severe during movement of the affected area.

Types of tendonitis that affect the foot and ankle include:

• Achilles tendonitis – causes pain at the heel and involves the Achilles tendon, which connects the heel bone to calf muscles
• Posterior tibial tendonitis – causes pain along the inside of the foot, where the posterior tibial tendon connects bones on the inside of the foot to calf muscles; it can lead to fallen arches (flatfoot)
• Peroneal tendonitis – causes pain on the outside of the ankle, where the peroneal tendon helps to stabilize the ankle to prevent ankle sprains
• Extensor tendonitis – causes pain across the top of the foot, where the extensor tendons (which helps lift up the toes) are located
• Flexor tendonitis – causes pain in the arch of the foot or at the inside of the ankle, where the flexor tendons (which allow the toes to bend) are located

Treatment of tendonitis begins with RICE (rest, ice, compression, elevation). Anti-inflammatory and pain medication may be recommended, especially if symptoms are mild. More severe symptoms may require steroid injections, physical therapy, or surgery to repair the damaged tendon and surrounding tissue.

Ingrown toenails are one of the most common toenail disorders. It involves the toenail growing into the skin surrounding the nailbed, often because the toenail is cut too short.

Fungal infections of the toenail are another common disorder, and these infections can be notoriously difficult to treat. An early sign of a toenail fungal infection is a light-colored spot under the top of the toenail. The nail itself slowly thickens, discolors, and becomes brittle.

Prescription antifungal cream can be used on the toenail to kill the infection, although it can take months for the infection to clear up. Some oral medications allow new, uninfected growth in the toenail, which ultimately replaces the infected portion of the toenail, although this process can take some time.

Also, laser therapy can be used to treat toenail fungal infections. This relatively new, noninvasive method targets the fungi under the nail without damaging the toenail. Patients of The Podiatry Group of South Texas can enjoy the convenience of this quick and easy in-office treatment.

Trauma to the toenail can also cause a host of problems such as the pooling of blood under the nail, the nail being severed from the nail bed, and injury to the toe bone.