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People come from around the world to the Foot Care Center.  We specialize in the cure of bunions, ingrown nails, hammertoes, heel and bone spursWe are conviently located throughout Southern California.

The foot is a complex structure of 26 bones and 33 joints, layered with an intertwining web of over 120 muscles, ligaments, and nerves. It serves the following functions:

  • Supports weight.
  • Acts as a shock absorber.
  • Serves as a lever to propel the leg forward.
  • Helps to maintain balance by adjusting the body to uneven surfaces.

Since the feet are very small relative to the rest of the body, the impact of each step exerts tremendous force upon them. This force is about 50% greater than the persons body weight. During a typical day, people spend about four hours on their feet and take between 8,000 and 10,000 steps. This means that the feet support a combined force equivalent to several hundred tons every day.

About Foot Pain

Given what the foot must endure, it is not surprising that about 75% of Americans experience foot pain at some point in their lives. According to one study, chronic and severe foot pain is a serious burden for one in seven older disabled women. To compound problems, the lower back is often affected by injuries or abnormalities in the feet.

Foot pain is generally defined by one of three sites of origin: the toes; the forefoot; and the hindfoot.

The Toes. Toe problems most often occur because of the pressure imposed by ill-fitting shoes.

The Front of the Foot (Forefoot). Pain originating in the front of the foot usually involves one of the following bone groups:

  • The metatarsal bones (five long bones that extend from the front of the arch to the bones in the toe).
  • The sesamoid bones (two small bones imbedded at the top of the first metatarsal bone, which connects to the big toe).

The Back of the Foot (Hindfoot). Pain originating in the back of the foot can affect parts of the foot extending from the heel, across the sole (known as the plantar) to the ball of the foot.

Foot Pain: Problems and Their Locations

Condition

Location

Symptoms

Recommended Footwear

Toe Pain

Corns and calluses

Around toes, usually little toe, bottom of feet or areas exposed to friction.

Hard, dead, yellowish skin.

Wide (box-toed) shoes; soft cushions under heel or ball of foot or customized or gel insoles for calluses. Doughnut-shaped pads for corns.

Ingrown toenails

Toenails.

Nail curling into skin causes pain, swelling, and, in extreme cases, infection.

Sandals, open-toed shoes.

Bunions and bunionettes (tailors bunion)

Big toe (bunions) or little toe (bunionettes).

Bunions consist of three components, which can occur alone or in combination:

Metatarsus primus varus. The first (big toe) metatarsal bone shifts away from the second, and the big toe points inward.

Medial exotosis. This is a bony bump at the base of the big toe, which protrudes outward. Area next to bony bump is red, tender, occasionally filled with fluid. Toe joint may be inflamed.

Hallux valgus. This is a deformity in which the bone and joint of the big toe shift and grow inward, so that the second toe crosses over it.

Soft, wide-toed shoes or sandals. Bunion shields or splints. Thick doughnut-shaped moleskin pads, custom-made orthotics or foot slings if necessary. Avoid shoes with stitching along the side of the "bump."

Mortons neuroma (also called interdigital neuroma)

Inflammation of the nerve between the third and fourth toes and bottom of foot near these toes.

Cramping and burning pain, or electric-shock sensation. The condition may produce a thick protective sheath around the nerve that feels like a ball. This may be detected by pressing top to bottom using one hand and with the other hand pressing on the top of the foot and moving it from side to side. Aggravated by prolonged standing and relieved by the removal of the shoes and forefoot massage.

Wide (box-toed) shoes. Orthotic or insole with pad that reduces stress on the painful area.

Hammertoe or clawtoe

Usually second toe but may develop in any or all of the three middle toes.

Toes form hammer or claw shape. In hammertoe, the first knuckle of the toe is mainly affected. In clawtoe the entire toe is deformed. No pain at first, increasing as tendon becomes tighter and toes stiffen.

Wide (box-toed) shoes. Toe pads or specially designed shields, splints, caps, or slings. (Splints or slings not for people with diabetes.)

Front-of-the-Foot Pain

Metatarsalgia

Ball of the foot.

Acute, recurrent, or chronic pain without a known cause.

Wide (box-toed) shoes. Orthotic with pad that reduces metatarsal pressure. Gel cushions. Metatarsal bandage.

Stress fracture

Most often in the area beneath the second or third toe.

Sudden pain when injury occurs, which persists.

Low-heeled shoes with stiff soles.

Sesamoiditis

Ball of foot beneath big toe.

Pain and swelling.

Low-heeled shoe with stiff sole and soft padding inside.

Heel and Back-of-the-Foot Pain

Plantar fasciitis and/or heel spurs

Back of the arch right in front of heel.

At onset, some people report a tearing or popping sound. Pain, most severe with first steps after getting out of bed, decreasing after stretching, returning after inactivity.

Over-the-counter foot insole (cut quarter-size hole surrounding painful area). Possible night splints. Orthotics if necessary.

Bursitis of the heel

Center of the heel.

Pain, with warmth and swelling. Increases during the day.

Heel cup.

Haglunds deformity (pump bump)

Fleshy area on the back of the heel.

Tender swelling aggravated by shoes with stiff backs.

Soft shoes. Heel pads. Possible orthotic to support heel.

Achilles tendinitis

Achilles tendon: area along the back between calf muscles and heel.

Pain worsens during physical activities (particularly running) after which the tendon usually swells and stiffens. If it ruptures, popping sound may occur followed by acute pain similar to a blow at the back of the leg.

Insoles, tendon strap, heel cups.

Arch and Bottom-of-the Foot Pain

Tarsal tunnel syndrome

Anywhere along the bottom of the foot.

Numbness, tingling, or burning sensations, pain, most commonly felt at night.

Specially designed orthotics to relieve pressure.

Flat feet or posterior tibial tendon dysfunction (PTTD)

The arch.

No arch. Often no pain or discomfort. Three stages in PTTD:

Pain and weakness in the tendon.

The arch flattens but is still flexible.

The foot becomes rigid and possibly painful at the ankle. Sometimes people report fatigue, pain, or stiffness in the feet, legs, and lower back.

For children, possible custom-made insoles.

High arches (hollow feet)

The arch.

High arches. Lower back pain, possible tendency to lower limb injuries.


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| Dr. Frederick Mayer | Dr. Nalli | | Dr. Peter Park | Dr. Pete Thomas
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FOOT CARE CENTER
Warner Village Building
10900 Warner Ave, Suite 121
Fountain Valley, California 92708