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Medical:  Foot Pain - Warts, Neuroma, Bone Spurs

Warts
Warts are common, benign skin tumors caused by infection with the human papillomavirus, which belongs to the DNA virus group. All age groups may be affected, but the condition occurs most frequently between ages 12 and 16 years. There are many types of warts.

As a rule, warts are asymptomatic, except when they occur on weight-bearing areas, such as the soles of their feet. They may be treated with locally applied laser therapy, liquid nitrogen, salicylic acid plasters, or electrodesiccation, such as the destruction of skin lesions by monopolar high-frequency electric current.

Plantar Warts
Warts occurring on the plantar surface are considered as “hyperkeratotic lesions.” Plantar warts usually grow on the “ball and heel” of the foot. This is the area where most pressure is applied. In the case of plantar warts, symptoms are present.

The main cause of plantar warts is the human papillomavirus or the HPV. The most common strains that cause plantar warts are 1, 2, and 4.

Treatment: In treating plantar warts, cryotherapy, topical keratinolytic treatments, and surgery are the most common medical management techniques.

Applying dichloroacetic acid, cantharidin, and salicylic acid on the affected area can be very helpful. Oral medication may also expedite the healing process. Normally, the administration of zinc sulphate to patients with plantar surface is necessary.

Neuroma

Morton’s neuroma, or otherwise known as neurofibroma, or plantar digital neuroma, is a swelling of the third or lateral branch of the median plantar nerve. The third digital nerve, which is located in the third intermetatarsal space, is most commonly involved. Microscopically, digital artery changes cause an ischema of the nerve.

The result is a throbbing, burning pain in the foot that is usually relieved when the patient rests. Conservative treatment consists of inserting innersoles and metatarsal pads designed to spread the metatarsal heads and balance the foot posture.

Treatment: Local injections of hydrocortisone and a local anesthetic may provide relief. If these fail, surgical excision of the neuroma is necessary. Pain relief and loss of sensation are immediate and permanent.

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Haglund’s Deformity:   Heel Spurs

A heel can hurt for many reasons—arthritis, a fracture, or a sore heel pad, to name a few. But the most common cause of heel problem seen by podiatrist is Haglund’s Deformity. Haglund’s deformity is a painful and discomforting condition of the heel, specifically at the back portion at the region of the placing of the “Achilles tendon.”

Within this region, the plantar fascia is located. Plantar fascias are bands of ligaments that stretch from the ball of the foot to the heel bone, holding the muscles at the bottom of the foot in place. If these ligaments are repeatedly stretched too far or twisted too much, such as when your shoes do not provide the right support or when you are exercising too hard, they tug at the heel bone, causing a bruise and inflammation that really hurts.

Extra calcium can accumulate at the site of the bruise and cause additional pain, a problem called a heel spur. Do not be surprised if Haglund’s deformity gives you a wake-up call the moment you step of bed. Typically, the pain is most intense in the morning when the ligaments are tight.

Treatment: In treating Haglund’s deformity, there are two possible forms of cure: surgical and non-surgical treatment. Non-surgical treatment consists of complete rest and total eradication of heeled shoes. The best way to prevent Haglund’s deformity is to wear a stable shoe.

If all else fails, podiatrists may opt for surgical treatment. Usually, patients with Haglund’s deformity undergo bump removal or wedge osteotomy.

Bump removal simply refers to the process of removing “bump.” On the other hand, wedge osteotomy refers to the removal of a “wedge of bone” from the calcaneus,” thereby, reducing the size.