Metatarsalgia

Metatarsalgia

Metatarsalgia is an overuse injury with resultant pain and inflammation in the ball of the foot.

The primary symptom is pain around the heads of the metatarsals sometimes described as the ball of the foot.  This can include burning and shooting sensations, numbness and tingling.

The pain can be aggravated with activities including walking, the high impact from running as well as other activities including soccer, baseball, tennis, etc.

Other contributing factors can be:

a) Wearing high heel shoes, shoes with a narrow and tapered toe box.

b) As we age, the fat padding under the metatarsal heads diminishes     allowing more pressure and thus inflammation.

c) Hammertoe deformities which raise the base of the proximal     phalanx higher on the metatarsal head and pushing it harder into   the ground.

d) Pronation, a high arched foot and an abnormal parabola of the   length of the metatarsal bones.

e) Obesity

f) Arthritic joint changes

The first step in treating metatarsalgia is to determine the cause of the pain.

If improper fitting footwear is the cause of the pain, modifications can relieve it. Shoes with a high/deep, wide/round/squared toe box relieve pressure in this area. A more supportive shoe can help to support the foot better and disperse pressure. No barefoot/slipper/stocking walking when on your feet in the house for prolonged periods.

Other modalities may include shoe padding, rocker bottom soles and orthotics.

If no other more serious issues are involved, general care including elevation and icing of the area may help.

Diabetic Foot Care

Diabetic Foot Care

Diabetes can damage the nerves and blood vessels in your feet.  This damage can cause numbness and reduce feeling in your feet. As a result, your feet may not heal well if they are injured.  If you get a blister, you may not notice and it may get worse.

Check your feet every day.  Inspect the tops, sides, soles, heels, and between your toes.  Look for:

    Dry and cracked skin
    Blisters or sores
    Bruises or cuts
    Redness, warmth, or tenderness
    Firm or hard spots

If you cannot see well, ask someone else to check your feet.

Call your health care provider right way about any foot problems you have.  DO NOT try to treat these problems yourself.  Even small sores or blisters can become big problems if infection develops or they DO NOT heal.  Foot ulcers are a common reason for hospital stays for people with diabetes.

Wash your feet every day with lukewarm water and mild soap.  Strong soaps may damage the skin.

    Check the temperature of the water with your hand or elbow first.
    Gently dry your feet, especially between the toes.
    Use lotion, petroleum jelly, lanolin, or oil on dry skin. DO NOT put lotion, oil, or cream between your toes.
    Your foot doctor (podiatrist) can trim your toenails if you are unable to.

 Most people with diabetes should have corns or calluses treated by a foot doctor.

DO NOT use medicated pads or try to shave or cut corns and calluses away at home.

If you smoke, stop.  Smoking decreases blood flow to your feet.  Talk to your provider or nurse if you need help quitting.

DO NOT use a heating pad or hot water bottle on your feet.  DO NOT walk barefoot, especially on hot pavement or hot, sandy beaches.
Shoes and Socks

Wear shoes at all times to protect your feet from injury.  Before you put them on, always check the inside of your shoes for stones, nails, or rough areas that may hurt your feet.

Wear shoes that are comfortable and fit well when you buy them.  Never buy shoes that are tight, not even if you think they will stretch as you wear them.  You may not feel pressure from shoes that DO NOT fit well. Blisters and sores can develop when your foot presses against your shoe.

To protect your feet, wear clean, dry socks or non-binding panty hose every day. Holes in socks or stockings can put damaging pressure on your toes.

You may want special socks with extra padding.  Socks that move moisture away from your feet will keep your feet drier.  In cold weather, wear warm socks, and DO NOT stay out in the cold for very long.  Wear clean, dry socks to bed if your feet are cold.
When to Call the Doctor

Call your provider if you have any of the following changes to any part of your foot:

    Redness, increased warmth, or swelling
    Sores or cracks
    Tingling or burning feeling
    Pain

Plantar Fasciitis

Plantar fasciitis 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, that runs across the bottom of your foot and connects your heel bone to your toes.
Plantar fasciitis commonly 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.
Plantar fasciitis is particularly common in runners. In addition, people who are overweight and those who wear shoes with inadequate support are at risk of plantar fasciitis.
      Plantar fasciitis typically causes a stabbing pain in the bottom of your foot near the heel. The pain is usually worst with the first few steps after awakening, although it can also be triggered by long periods of standing or getting up from a seated position.
      Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. If tension on that bowstring becomes too great, it can create small tears in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed.
     
Factors that may increase your risk of developing plantar fasciitis include:

• Age. Plantar fasciitis is most common between the ages of 40 and 60.
• Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and dance aerobics — can contribute to an earlier onset of plantar fasciitis.
• Faulty foot mechanics. Being flat-footed, having a high arch or even having an abnormal pattern of walking can adversely affect the way weight is distributed when you're standing and put added stress on the plantar fascia.
• Obesity. Excess pounds put extra stress on your plantar fascia.
• Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can damage their plantar fascia.
•       Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities. If you change the way you walk to minimize plantar fasciitis pain, you might also develop foot, knee, hip or back problems.

Neuromas

Neuromas
A neuroma is a painful condition, also referred to as a “pinched nerve” or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes. It brings on pain, a burning sensation, tingling, or numbness
between the toes and in the ball of the foot.
The principal symptom associated with a neuroma is pain between the toes while walking. Those suffering from the condition often find relief by stopping their walk, taking off their shoe, and rubbing the affected area. At times, the
patient will describe the pain as similar to having a stone in his or her shoe. The vast majority of people who develop neuromas are women.
Although the exact cause for this condition is unclear, a number of factors can contribute to the formation of a neuroma:
Biomechanical deformities, such as a high-arched foot or a flat foot, can lead to the formation of a neuroma. These foot types bring on instability around the toe joints, leading to the development of the condition.
Trauma can cause damage to the nerve, resulting in inflammation or swelling of the nerve.
Improper footwear that causes the toes to be squeezed together is problematic.
Avoid high-heeled shoes higher than two inches. Shoes at this height can increase pressure on the forefoot area.
Repeated stress, common to many occupations, can create or aggravate a neuroma.
The symptoms of a neuroma include the following:
Pain in the forefoot and between the toes
Tingling and numbness in the ball of the foot
Swelling between the toes
Pain in the ball of the foot when weight is placed on it

Bunions

Bunions
A bunion is a “bump” on the joint at the base of the big toe—the metatarsophalangeal (MTP) joint—that forms when the bone or tissue at the big toe joint moves out of place. The toe is forced to bend toward the others, causing an often painful lump of bone on the foot. Because this joint carries a lot of the body's weight while walking, bunions can cause extreme pain if left untreated. The MTP joint itself may become stiff and sore, making even the wearing of shoes difficult or impossible. A bunion—from the Latin "bunio," meaning enlargement—can also occur on the outside of the foot along the little toe, where it is called a "bunionette" or "tailor's bunion".
Bunions form when the normal balance of forces that is exerted on the joints and tendons of the foot becomes disrupted. This disruption can lead to instability in the joint and cause the deformity. Bunions are brought about by years of abnormal motion and pressure over the MTP joint. They are, therefore, a symptom of faulty foot development and are usually caused by the way we walk and our inherited foot type or our shoes.
Although bunions tend to run in families, it is the foot type that is passed down—not the bunion. Parents who suffer from poor foot mechanics can pass their problematic foot type on to their children, who in turn are prone to developing bunions. The abnormal functioning caused by this faulty foot development can lead to pressure being exerted on and within the foot, often resulting in bone and joint deformities such as bunions and hammertoes.
Other causes of bunions are foot injuries, neuromuscular disorders, or congenital deformities. People who suffer from flat feet or low arches are also prone to developing these problems, as are arthritic patients and those with inflammatory joint disease. Occupations that place undue stress on the feet are also a factor; ballet dancers, for instance, often develop the condition.
Wearing shoes that are too tight or cause the toes to be squeezed together is also a common factor, one that explains the high prevalence of the disorder among women.
The symptoms of a bunion include the following:
Development of a firm bump on the outside edge of the foot, at the base of the big toe
Redness, swelling, or pain at or near the MTP joint
Corns or other irritations caused by the overlap of the first and second toes
Restricted or painful motion of the big toe