Forefoot Pain

Pain in your forefoot could be either: Irritation of the tendons (Tendinitis), soft tissues injury when you stub your toe or drop a heavy item on your foot, excessive pressures under the ball of your foot (Metatarsalgia), nerve like pain between your toe interspaces (Neuroma), soft tissue mass (Ganglion Cyst, Fibroma, Lipoma), or bone fracture.

Tendinitis

It is a condition associated with overuse injury or deformity of your foot. You normally would having pain along the tendon course, or at its insertion into the bone. Treatments can be consisting of using over the counter arch support such as SuperFeet, custom functional orthotics, NSAIDS such as Motrin, Relafen, Naproxen. I may also offer a cortisone injection. For severes tendinitis, I may need to treat it with casting or removeable walker for immobilization and allow the tendon to rest.

Soft Tissue Injury

Associates with swelling and pain at the injury area. Use RICE: Rest, Ice, Compression, Elevation. NSAIDS medication will also help. Contact your primary care physician if it is not getting better in 2-3 days. Severes swelling may lead to a serious condition known as compartment syndrome.

Metatarsalgia

Mostly cause by non-supportive shoes. It can be worst when you don't have much fat padding under the ball of your foot. If you have metatarsalgia, don't wear high heel shoes or flipflops. They don't give you any support under your feet. Try wearing well-fitted athletic shoe with more supportive insoles. NSAIDS medication will also help.

Neuroma

It is another condition which may be caused by tight shoes. My patients tell me that it seems like that they are walking on a pepble under the foot with sharp shooting pain radiating to the adjacent toes. Treatment is consisting of wearing wider shoe, NSAIDS medication, arch support, paddings. I may also offer a cortisone injection. Surgery may be indicated if you continue to have neuroma like pain after conservative treatments.

Ganglion Cyst

This is the most common soft tissue mass that I see in the clinic. It is usually round and seems to grow just underneath the skin. Ganglion cyst is cause by traumatic injury to the foot: ie. tight shoe, dropping a heavy object on top of your foot. Treatment consisting of draining the cyst with a needle - after locally anesthetized the affected area. I also inject a small amount of cortisone into the cyst itself.

Plantar Fibromatosis

These are soft tissue mass which are growing under the foot and along the plantar fascia bands. I would offer a cortisone injection for treatment. This will help shrink down the mass size. For larger one, surgery can also be done to remove the entire plantar fibromatosis.

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