Lyndon Johansen DPM

What is a Neuroma?

Morton's neuroma is a common, benign growth found between the third and fourth toes. You'll most often hear it referred to as a "pinched nerve." The main symptom associated with this type of neuroma is pain at the area of the growth and the ball of your foot. In some cases, you might also experience burning, tingling, or numbness. Some liken the pain to standing on a pebble in your shoe or on a fold in your sock. Untreated, this constant compression will cause the nerve to enlarge and may eventually lead to permanent nerve damage.

These types of neuromas are commonly linked to wearing high-heeled or tight shoes. Switching to lower-heeled shoes with wider toe boxes may relieve pain and prevent permanent nerve damage.

Causes

The most common cause of a neuroma stems from wearing high-heeled shoes or shoes with narrow toe boxes. But anything causing constant compression or irritation to the nerve can lead to its development.

People with other foot disorders like bunions, hammertoes, or flat feet and athletes whose activities require them to irritate the ball of the foot are more likely to develop a neuroma.

Symptoms
Symptoms of a neuroma usually develop over time with intermittent occurrences of pain occurring when wearing certain footwear or engaging in specific activities. You might find temporary relief by removing tight shoes, massaging your foot or avoiding activities causing pain to the affected area. But, over time symptoms will worsen and may even persist for several days or weeks. And as the neuroma enlarges, symptoms will likely become more intense.

If you are experiencing any of the following symptoms, you may have a neuroma.
• Pain in the ball of your foot between the third and fourth toes.
• Tingling, burning, or numbness in the ball of the foot.
• Swelling between the third and fourth toes.
• Pain when placing weight on the ball of your foot.

Diagnosis and Treatment

If you are experiencing any of the symptoms listed above, it's best to reach out to your podiatrist for a diagnosis right away. Your doctor will complete a physical examination and try to reproduce your symptoms during the exam or request for x-rays and other tests to be administered. Early detection of a neuroma may prevent surgery.

Treatments are prescribed depending on the severity of the neuroma. If your neuroma is in its beginning stages, you might find a pair of thick-soled shoes with a wide toe box sufficient. But, for more serious conditions, you may need advanced treatment and possibly surgery. Your doctor will provide a thorough examination and suggest a treatment plan based on the results.

Common treatments include:

Padding: Specialized padding at the ball of the foot may alter any abnormal foot function and alleviate symptoms caused by the neuroma.

Medication: Prescribed anti-inflammatory drugs and cortisone injections can be administered to ease pain caused by the neuroma.

Orthotics: Customized shoe inserts prescribed and made by your podiatrist may help control foot function and reduce symptoms preventing the worsening of the condition.

Surgical Options: Podiatric outpatient surgery may become necessary when early treatments fail and the neuroma progresses past the threshold of non-invasive options. Surgical procedures are performed to remove the inflamed and enlarged nerve with a recovery time of just a few weeks.

Prevention

The exact causes of neuromas are unknown, but avoiding the following will certainly help prevent a neuroma from developing.

• Ensure exercise shoes have enough room in the toe box and that your toes have room.
• Wear shoes with enough padding, especially in the ball of the foot.
• Avoid wearing shoes with a narrow toe box or excessive heel height of greater than two inches.

If you think you may be experiencing a neuroma, contact our office to schedule an examination.

What is Plantar Fasciitis?

Plantar Fasciitis is one of the most common causes of pain in the heel. The ligament connecting your heel to the front of your foot is called the plantar facia. It absorbs the shock of walking or running and supports the arch of your foot. Over our lifetime, these ligaments may become susceptible to inflammation, causing heel pain and stiffness.

What are the symptoms?

Plantar fasciitis commonly causes stabbing pains at the bottom of the heel or middle of the foot. Both feet can experience this pain, although it’s typically just one.

Most people who suffer from plantar fasciitis experience pain with their first steps in the morning and find the pain diminishes once they get moving. However, the pain typically returns after long periods of standing or after long periods of sitting or lying down.

When a person is active, and on their feet for long periods, plantar fasciitis’s painful symptoms can flare up due to increased inflammation. Most people don’t experience the pain during increased activity but will feel the discomfort right after.

How is it caused?

Plantar Fasciitis is most common in women. Ordinarily active men and women between 40 and 70 develop plantar fasciitis for varying reasons, including:

Pregnancy: Pregnant women may experience plantar fasciitis later in their pregnancy.

Obesity: Generally due to increased pressure on the plantar fascia ligaments, especially if there is sudden weight gain.

Activity: Runners, or people standing on their feet for long periods at work, are more susceptible.

Foot Structure: People with high arches or flat feet can cause plantar fasciitis, or if you continually wear soft sole or low arch support shoes.

How is it treated?

Common home treatments like rest, ice, heat, anti-inflammatory medications are where we start treating plantar fasciitis. If this doesn’t ease the discomfort, your doctor may use cortisone injections, splints, braces, or physical therapy and custom orthotics.

Other modalities can help with these symptoms if they become chronic, such as platelet injections, radiofrequency therapy, and surgery. Surgery can be beneficial if other treatments fail.

Recent endoscopic plantar fascial releases have been very successful for those candidates opting for surgery with minimal foot invasion and quicker recovery.

Some other causes of heel pain may be a tarsal tunnel, bursitis, posterior heel pain, and stress fractures.

How long does it last?

Most people find Plantar Fasciitis improves after just a few months of using the home remedies described above.

When active, it does help to stabilize your foot with tape to limit the amount your foot can move. And taping may provide temporary relief of heel pain.

Surgery is typically not needed for most people suffering from plantar fasciitis. When mindful use of home therapies is adopted, conditions will improve. However, you may need to use these remedies for several months to years.

How to Relieve Bunion Pain

What are bunions?
A bunion is a bony bump of the big toe joint on your foot – the metatarsophalangeal (MTP) joint. Bunions can be very painful and develop over time due to pressure on this joint changing its structure. The deformity tends to increase gradually, making it painful to wear shoes or walk.
Hallux valgus can be associated with a bunion which is the big toe turning toward the 2nd toe.
Who can get a bunion?
Anyone can get a bunion, but bunions are typically more problematic with women and older individuals than men or younger people.
How do I know if I have a bunion?
The most obvious signs of a bunion are a bump on the side of your big toe or your big toe turned inward, pressing against the others. You may also see redness and experience pain in your big toe joint area due to a growing bunion irritated by footwear.
It's also important to remember that bunions start small and grow slowly, so look for hardened skin or a callus on the side of the foot and tenderness or pain at the base of the foot's big toe and ball area.
What Causes Bunions?
Bunions are hereditary and can be seen in both men and women. Women seem to have more problems with bunions because women's shoes seem to be tighter and make bunions more symptomatic.
Bunions are usually related to certain foot types. Children can have bunions but this is rare.
Treating Bunions
There are a couple of ways to treat bunions depending upon how problematic they are for you. You can opt for a non-surgical remedy, or your doctor may recommend surgery.
Some non-surgical remedies include:
• Wearing shoes that are roomy in the toe box (choose shoes based on comfort instead of size)
• Over-the-counter, non-medicated bunion pads or cushions to create a barrier between your shoe and your foot.
• Icing your bunion to relieve soreness or swelling after being on your feet for long periods.
• Shoe inserts to distribute the pressure evenly throughout your shoe to prevent the bunion from worsening.
• Anti-inflammatory medications such as ibuprofen or naproxen can temporarily relieve pain and reduce swelling.
When Should I have surgery for my bunions?
If you have difficulty walking or the pain is unmanageable, your doctor may recommend surgery. There are several surgical procedures to correct bunions with same-day options that don't require a hospital stay.
There are many types of bunion surgery and depending on the deformity the doctor would discuss the best procedure for your bunion.
Lapiplasty® 3D Bunion Correction is a new, patented treatment for bunion correction. It's a new treatment option that does more than removing "the bump." It addresses your bunion in three dimensions to correct the problem at its root.
Lapiplasty® 3D Bunion Correction uses advanced fixation technology to secure the correction in place, allowing patients to walk within days of surgery. You'll be able to walk in a surgical boot in a few days instead of 6-8 weeks and get back to a better quality of life faster.

Fun Facts About Your Feet | Visual.ly Did you know that there are more than 200 muscles, ligaments, and tendons in the feet? That is why so many people suffer from foot problems! Click ove

Foot Health Facts The most common neuroma in the foot is a Morton’s neuroma, which occurs between the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma.