- Foot Conditions
Foot Conditions
Eight common conditions affecting the foot, explained clearly from first symptoms through to diagnosis, treatment and recovery, under the care of a Consultant Foot & Ankle Surgeon.
A bunion is one of the most common conditions affecting the foot. It develops when the big toe gradually drifts towards the smaller toes, causing a bony prominence on the inside of the foot. Over time, the deformity may worsen, making footwear uncomfortable and affecting walking and daily activities.
SYMPTOMS
- Pain over the bunion, particularly when wearing shoes
- Swelling and redness
- Difficulty finding comfortable footwear
- Progressive deformity of the big toe
- Crowding or deformity of the lesser toes
- Reduced walking tolerance
Diagnosis
Diagnosis is usually straightforward, involving clinical examination together with weight-bearing X-rays to assess the deformity and guide treatment.
Treatment
Many patients find relief with wider footwear, activity modification, insoles, and pain relief. Surgery is considered when symptoms persist or the deformity interferes significantly with daily life. Mr Rashid performs both minimally invasive and open bunion correction, tailored to severity and the individual patient.
Recovery
Most patients weight-bear immediately after surgery in a specialised post-operative shoe. Swelling settles gradually over several months; many return to desk-based work within two to four weeks. Full recovery typically takes three to six months.
Expected Outcome
An excellent success rate, reliable pain relief, improved alignment, and a return to comfortable footwear for the vast majority of patients.
Hallux rigidus is arthritis of the joint at the base of the big toe. As the cartilage wears away, the joint becomes stiff and painful, making walking, climbing stairs, and sporting activities increasingly difficult.
SYMPTOMS
- Pain when walking, particularly during push-off
- Stiffness of the big toe
- Swelling around the joint
- Difficulty wearing certain footwear
- A painful bony prominence on top of the joint
Diagnosis
Weight-bearing X-rays confirm the diagnosis and demonstrate the severity of the arthritis.
Treatment
Early arthritis may respond to footwear modification, stiff-soled shoes, activity modification, and anti-inflammatory medication. When symptoms persist, surgical options include:
- Joint preservation procedures
- Cheilectomy (removal of bone spurs)
- Cartiva implant (in selected cases)
- First metatarsophalangeal joint fusion the gold standard for advanced arthritis
Recovery
Most patients weight-bear immediately in a protective shoe. Recovery depends on the procedure; joint fusion typically requires six weeks of protected weight bearing while the bone heals.
Expected Outcome
The majority of patients experience excellent pain relief and a significant improvement in function following surgery.
Hammer toes, claw toes, and mallet toes occur when the smaller toes gradually bend due to muscle imbalance, arthritis, or longstanding pressure from footwear. The deformities may initially be flexible but often become fixed over time.
SYMPTOMS
- Pain over prominent joints
- Corns and calluses
- Difficulty fitting into shoes
- Toe deformity
- Pain beneath the ball of the foot
Diagnosis
Made through clinical examination and, where appropriate, weight-bearing X-rays.
Treatment
Conservative treatment includes footwear modification, padding, and orthoses. Surgery is considered if pain persists or the deformity becomes rigid, tailored to each patient and may involve tendon balancing, joint correction, or small bone procedures.
Recovery
Most patients walk immediately in a post-operative shoe. Swelling improves steadily over several weeks, with most returning to comfortable footwear after six to eight weeks.
Expected Outcome
Surgery aims to improve toe alignment, relieve pain, and allow patients to wear normal footwear comfortably.
Metatarsalgia describes pain beneath the ball of the foot. It’s a symptom rather than a diagnosis, and may result from overload, deformity, arthritis, instability, or abnormal foot mechanics.
SYMPTOMS
- Pain beneath the forefoot
- Walking discomfort
- Feeling as though walking on pebbles
- Pain that worsens with prolonged standing or activity
Diagnosis
A detailed assessment is essential to identify the underlying cause. Weight-bearing X-rays and, occasionally, MRI or ultrasound scans may be required.
Treatment
Treatment usually begins with footwear advice, orthotics, physiotherapy, and activity modification. Surgery is reserved for patients with a specific structural abnormality where conservative treatment has failed.
Recovery
Recovery depends on the procedure performed, although many forefoot operations allow immediate protected weight bearing.
Expected Outcome
Successful treatment depends on accurately identifying and correcting the underlying cause of the overload.
Morton’s neuroma is a painful condition affecting the nerve between the toes, most commonly between the third and fourth toes. It results from irritation and thickening of the nerve.
SYMPTOMS
- Burning pain in the forefoot
- Tingling or numbness in the toes
- A sensation of walking on a pebble
- Pain worsened by tight footwear
Diagnosis
Usually clinical, and may be confirmed with ultrasound or MRI scanning.
Treatment
Initial treatment includes wider footwear, orthotics, and steroid injections. Surgery to remove the neuroma is considered when symptoms remain troublesome despite conservative management.
Recovery
Patients usually walk immediately in a post-operative shoe, with most returning to normal footwear within four to six weeks.
Expected Outcome
The majority of patients achieve excellent pain relief following surgery, although some residual numbness between the toes is expected.
Plantar fasciitis is the most common cause of heel pain in adults. It occurs when the thick ligament beneath the foot becomes inflamed where it attaches to the heel bone.
SYMPTOMS
- Sharp pain beneath the heel
- Pain on taking the first steps in the morning
- Pain after periods of rest
- Symptoms that ease with walking before worsening later in the day
Diagnosis
Usually made clinically. Imaging is occasionally required to exclude other causes of heel pain.
Treatment
Most patients recover without surgery, through stretching exercises, physiotherapy, supportive footwear, orthotics, shockwave therapy and, in selected cases, injection therapy.
Recovery
Improvement is gradual and may take several months. Surgery is only very rarely required.
Expected Outcome
More than 90% of patients improve with non-operative treatment.
Adult-acquired flatfoot develops when the supporting structures of the foot, particularly the posterior tibial tendon, become weakened. This causes the arch to collapse, leading to pain, deformity, and difficulty walking.
SYMPTOMS
- Pain along the inside of the ankle
- Progressive flattening of the foot
- Difficulty standing on tiptoes
- Swelling and fatigue with walking
Treatment
Early cases often respond to physiotherapy, orthotics, and supportive footwear. Progressive deformity may require reconstructive surgery, including tendon reconstruction, osteotomies, and ligament reconstruction.
Recovery
Following reconstructive surgery, patients are usually non-weight-bearing for approximately six weeks before progressing gradually into a walking boot and physiotherapy programme.
Expected Outcome
Reconstructive surgery aims to restore foot alignment, reduce pain and preserve long-term function.
A cavovarus foot is a high-arched foot deformity that may develop due to neurological conditions or muscle imbalance. It often causes ankle instability, recurrent sprains, pain, and abnormal loading of the foot.
SYMPTOMS
- High foot arch
- Frequent ankle sprains
- Pain beneath the foot
- Calluses
- Difficulty walking on uneven ground
Treatment
Depends on the severity of the deformity and may include orthotics, physiotherapy, or complex reconstructive surgery involving tendon transfers, osteotomies, and ligament reconstruction.
Recovery
Following reconstruction, patients are usually non-weight-bearing for six weeks before gradually progressing to weight-bearing in a walking boot under physiotherapy supervision.
Expected Outcome
The aim is a stable, plantigrade foot that relieves pain, improves walking, and reduces the risk of future ankle instability.
About Mr Rashid
Mr Anjum Rashid is a Clinical Lead and Consultant Orthopaedic Foot and Ankle Surgeon at James Cook University Hospital, Middlesbrough. He also works at Tees Valley Hospital, Woodlands Darlington, and Tyneside Surgical Services Newcastle.
Contact Info
Middlesbrough · Darlington · Newcastle