Foot Pain Part 7
Warts, Neuroma, and Stress Fractures

Disabilities of the foot are commonly caused by poorly fitting shoes.

Fashion, vanity, and eye appeal, rather than function and physiology of the foot, are the determining factors in the design of footwear.

Ill-fitting shoes distort normal anatomy while inducing deformity and pain.

Several systematic diseases affect the feet.

Patients with diabetes are prone to develop corns and peripheral neuropathies with diminishing sensation, leading to ulcers at pressure points of the foot.

Patients with peripheral vascular disease and arteriosclerosis complain of burning and itching feet resulting in scratching and skin breakdown.

Foot deformities may occur with rheumatoid arthritis. Dermatology problems commonly affect the feet in the form of fungal infection and plantar warts.

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.

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.

As mentioned, warts are, generally, asymptomatic or without clear signs of the ailment.  However, 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. These strains cause warty growth in the plantar surface.

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.

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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Stress Fractures

Stress fractures are small breaks in the continuity of bone. They occur when the bone is subject to stress greater than it can absorb. Stress fractures are caused by overuse and recurring stress.

When the bone is broken, adjacent structures are also affected, resulting in soft tissue edema, hemorrhage into the muscles and joints, joint dislocations, ruptured tendons, severed nerves, and damaged blood vessels.

In essence, stress fractures are considered as sports-related injuries because most overuse happens during a sports activity.

Stress fractures can be avoided by using proper equipments such as wrist guards for skaters or running shoes for joggers. Effective training and conditioning can also help prevent stress fractures.

Treatment

Generally, there are no special treatments with stress fractures. Health experts commonly recommend complete rest in cases of minor to tolerable stress fractures.

However, patients who have experienced a sports-related injury are often highly motivated to return to their previous level of activity. But this should be done slowly and should be increases as the body and the bones are able to cope up with the demands of the activity again.

Indeed, you should keep those feet moving to ward off foot ailments and steer clear from pain and suffering. Exercise, avoid sitting with your legs crossed for more than a few minutes at a time, and periodically stretch your legs and toes. Putting up your feet when you are at rest can also help blood flow.

Once you have followed these simple rules, you will definitely have happier feet.