Finding a lump under your foot may be worrisome, but is it something you should be concerned about? It’s not uncommon to find all kinds of skin changes, lumps, and bumps in various places on our bodies, especially as we age. Some are harmless and benign while others should be evaluated and treated.
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1. Calluses
Calluses are among the most common skin conditions we see in our office. Calluses are a thickening of the skin that occur in response to too much pressure and are often found on the bottom of the feet. While they are benign, they can cause pain when walking or running.
Causes of Calluses
Some of the ways calluses develop are:
- Wearing shoes that increase pressure or friction on the bottom of the foot.
- Wearing shoes without socks
- Having another foot condition such as hammertoe which can put more pressure on your foot.
- Family history - you can inherit a tendency to develop calluses on the bottom of your foot
Treatment of Calluses
While it’s necessary to remove calluses for comfort it’s essential if you have a condition like diabetes. Patients with diabetes or another circulatory problem can develop wounds if calluses aren’t removed.
Prevention of Calluses
- Wear shoes that fit well and provide plenty of room in the toe box. Shoes should have a heel of one inch or less to reduce pressure on the ball of the foot.
- Patients with diabetes may be fit with special diabetic shoes and inserts designed to prevent friction.
- Wear socks that wick away moisture.
- Never wear closed-toed shoes without socks.
- Pads and cushions – you may purchase a pad or cushion to cover the area that tends to develop a callus
2. Plantar Warts
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Plantar warts are common in adults and children. They are caused by the Human Papilloma Virus (HPV). They can cause sharp, burning pain on the bottom of the feet. They should be removed since they can spread to other parts of the body, and to others, and can cause great discomfort.
Causes of Plantar Warts
- Walking barefoot where the virus thrives such as pools, locker rooms, and yoga studios.
- Sharing towels, razors, and other personal items.
- Having cuts and scrapes on the feet for easy virus entry
- People with a weakened immune system can more easily develop HPV
Treatment of Plantar Warts
Plantar warts can be treated through a variety of methods including:
- Chemical application (cantharone)
- Freezing
- Surgical removal
- Immune therapy (Swift) – our office uses this newer treatment which has a much lower recurrence rate than other modalities.
3. Plantar fibroma
Plantar fibromas are benign or non-cancerous growths found in the plantar fascia, the ligament that runs along the bottom of your foot. Fibromas can be painful and often get larger without treatment.
Treatment of Plantar Fibromas
- Cortisone to shrink it and relieve the pain.
- Custom orthotics can help remove pressure on the fibroma.
- Surgery is done when none of the other treatments help. Unfortunately, there is a high rate of recurrence.
4. Ganglion Cyst
Often confused with fibromas, ganglion cysts found on the bottom of the foot are fluid-filled lumps appearing along tendons and joints. The pain is caused by pressure from shoes, but tingling and burning can develop when the cyst is found near a nerve.
Ganglion cysts are most likely caused by:
- Trauma to the foot
- Constant pressure and stress on the foot
- Irritation to the tendons and joints.
- Women are more at risk than men
Treatment for Ganglion Cysts
- If you aren’t feeling any pain, no treatment is necessary.
- Draining the cyst
- Cortisone
- Surgical removal is the only method to use to prevent recurrence
5. Morton’s neuroma
Morton’s neuroma is a benign growth of nerves that develop between the 3rd and 4th toes. In the early stages of this condition, many people say they notice a lump or pebble under their foot. They may also feel some pain that comes and goes in the ball of the foot. But as it progresses the pain becomes more constant making it difficult to walk or participate in sports.
Causes and Risk Factors for Morton’s Neuroma
- Wearing high heels and shoes that pinch the toes
- Other foot conditions such as flat feet, hammertoes, and bunions
- Trauma to the foot
- Runners or other active people
Treatment of Morton’s Neuroma
- Wearing shoes with a wider toe box and flatter heel.
- Custom orthotics to help remove pressure on the ball of the foot
- Metatarsal pad to remove pressure on the nerves
- Guided ultrasound injections of alcohol to shrink the neuroma
- MLS laser therapy to reduce pain and inflammation.
- Surgical removal if all conservative treatments fail.
