Common Foot and Ankle Problems Successfully Treated by SoCal Podiatrist Dr. Vladimir Zeetser
Foot and ankle problems usually fall into the following categories:
Acquired from improper footwear, physical stress, or small mechanical changes within the foot.
Arthritic foot problems, which typically involve one or more joint.
Congenital foot problems, which occur at birth, are generally inherited.
Infectious foot problems, which are caused by bacterial, viral, or fungal disorders.
Neoplastic disorders, usually called tumors, which are the result of abnormal growth of tissue and may be benign or malignant.
Traumatic foot problems, which are associated with foot and ankle injuries.
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The most commonly treated foot problems are: (all descriptions are mainly in laymen's terms)
Bunion Deformity (Hallux Abductovalgus)
A bunion deformity is a misaligned big toe joint that can become swollen and tender, causing the big toe to deviate towards the second toe and a bump or bunion to form on inside (medial aspect) of the big toe joint. As time progresses, the angle between the first and second metatarsal bones increases and the bunion becomes larger.
Stiff Big Toe (Hallux Limitus/Rigidus)
This is a condition that affects the same joint as a bunion, however on the top rather than the side. This is the result of arthritic and degenerative changes occurring at the joint from wear and tear. Typically, spurs or bony growths form on the top of the joint causing pain and restricting motion.
Tailor's Bunion or Bunionette
This is the equivalent to a bunion but is present on the outside of the foot at the fifth metatarsal bone. Causes and treatments are generally the same as for a bunion deformity.
Plantarflexed or Dropped Metatarsal
Clinically, this can present as an isolated painful callus or bone pain at the ball of the foot usually under the second metatarsal. Although any of the lesser metatarsals can be affected, typically the second metatarsal is too long or angled downward more than the others.
One of the most common conditions affecting the foot and usually stemming from muscle imbalance, in which the toe is bent into a contracted claw-like position.
Heel Pain, Plantar Fasciitis and Heel Spur Syndrome
This general category results in pain to the inside (medial aspect) of the heel which can occur suddenly or have a gradual onset. It occurs from excessive tension on the plantar fascia, the tendon attaching on the bottom of the heel bone, which results in microtearing and inflammation. With time and continued stress, the muscle pulls at its attachment to the heel bone and eventually produces a calcified spur visible on x-ray.
Flat Foot Deformity
This condition can be congenital or acquired and typically results in hyperpronation of the subtalar joint in the foot. A variety of other causes occur as well. Gradually, the medial arch collapses and the foot becomes progressively flatter.
Toenails whose corners or sides dig painfully into the skin. Ingrown toenails are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity and poor foot structure.
Enlarged benign growths of nerves, most commonly between the third and fourth toes. They are caused by tissue rubbing against and irritating the nerves. The symptoms include burning, numbness or cramping between the toes or in the ball of the foot.
Hallux Pinch Callus
This is a painful callus seen along the side of the great toe. A simple procedure removes the bony prominence which is the underlying cause of the hard callus formation.
This usually presents as a red, hot, swollen joint (most commonly the big toe joint). The pain is usually severe and causes limping. This is a metabolic disorder associated with elevated uric acid levels in the blood, mainly from dietary sources. If untreated, long term damage to the joint can occur, occasionally requiring surgery.
This is usually a benign soft tissue mass filled with a thick jelly like fluid. They often arise from a joint capsule or tendon sheath. A lump beneath the skin can cause pressure on a nearly nerve or pain in shoes.
An ankle sprain is an injury to one or more ligaments to the ankle joint, usually on the outside (lateral aspect). These typically occur from twisting motions of the joint during a fall or from direct trauma. Early aggressive treatment typically yields the best results and fastest recovery.
This presents as pain directly beneath the 1st metatarsal (big toe joint) caused by inflammation or damage to any of the two small bones (sesamoids). Treatment includes offloading in a special shoe, orthotics, cortisone injections and occasionally surgical removal of bone fragments.
Plantar Wart or Verruca
Caused by strains of Human Papilloma Virus (HPV), this is probably the most difficult to resolve dermatological condition on the feet. Due to the high recurrence rate, a multitude of treatment options are available, but most are ineffective for warts on the bottom surface of the foot.
Tendonitis (Achilles Tendonitis)
Inflammation of a tendon or the tissue surrounding it is called tendonitis. Pain is typically felt with motion of the tendon or weightbearing. Any tendon in the foot may be involved, however the Achilles tendon is most commonly affected.
Pump Bump (Haglund's Deformity)
This is typically seen on the back of the heel as an enlarged swelling underneath the Achilles tendon. Usually caused by an enlarged bone mass with overlying tissue swelling on the back of the heel, which may take years to develop.
Pain to either side of the leg (tibia) bone, caused by muscle or tendon inflammation. It is commonly related to excessive foot pronation (collapsing arch), but may be related to a muscle imbalance between opposing muscle groups in the leg.
This presents as a gradual onset of pain (usually in the midfoot) caused by overuse. Stress fractures are small incomplete cracks in bone and with early diagnosis and treatment, the condition typically heals completely.