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Burning Feet (Neuroma)
A neuroma is a painful swelling of a nerve, usually in the ball or heel of the foot. Symptoms include sporadic pain; burning, tingling or numbness of one or more toes; and a popping sensation when walking. Pain is often soothed by taking weight off the foot or by massaging the area.
In the foot, there are the long bones (metatarsals) and thin nerves running between them. The nerves split in a Y-shape when they reach the toes. If the metatarsals move abnormally, they can pinch the nerve between them, causing inflammation and, eventually, permanent nerve damage. Morton’s Neuroma is the most common of this type and affects the nerve between the third and fourth toes. Neuromas may also occur after a nerve has been injured, either from a traumatic wound or from damage suffered during surgery.
A physical examination and one or more imaging tests will determine whether the pain is caused by a neuroma or by a condition with similar symptoms such as arthritis, stress fractures, tendon inflammation, tarsal tunnel syndrome and nerve compressions in the ankle or leg. Treatment begins with a combination of cortisone injections to reduce swelling and orthotic inserts to correct problematic metatarsal movement. If the nerve is permanently damaged, the patient may decide to undergo chemical destruction of the nerve, have the nerve surgically removed, or endure the pain.
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Orthotics
Orthotics are shoe inserts that correct the way the foot moves while standing, walking, running or playing a sport. In addition to making these activities more comfortable and efficient, orthotics treat problems with the feet, ankles, knees, hips or back that are due to abnormal movements of one or both feet. They offer an effective conservative approach to treating certain foot and ankle problems and controlling movement after foot surgery.
Orthotics are designed to either alter foot function, protect the foot, or both. They may be rigid, to control movement; soft, to absorb shock, improve balance and ease pressure on sore spots; or semi-rigid, with dynamic layers of rigid and soft materials, to assist athletes. There are orthotics for children and orthotics to fit a variety of sports footwear such as skates and ski boots.
Sometimes, over-the-counter inserts are enough to improve the problem. For all other cases, our physicians will conduct an examination and make a cast of your foot in order to construct custom-made orthotics to fit your individual feet for the most effective results.
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Corns
Corns are similar to calluses in that they are formed by an accumulation of dead skin cells that create thick, hardened areas on the skin of the feet. The corns themselves have a cone shaped core, the point of which can cause pain by pressing down on a nerve. Corns usually form on the tops, sides, and tips of the toes, and are quite common.
Corns can develop as a result of wearing tight fitting shoes or high heels, tight fitting socks or stocking, and friction caused by the sliding motion of the foot in loose fitting shoes. There are a variety of treatment options for corns. Consult your physician for the best treatment for your specific case.
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Warts
Warts are skin growths caused by viruses. Different warts respond to different treatments. Some go away on their own. Salicylic acid products (in the form of drops, gels, pads and bandages) can help self-treatment of many warts by dissolving the keratin protein that makes up the wart and the dead skin above it. Others can be removed via liquid nitrogen freezing or electrical stimulation. Surgery may be recommended for painful or large warts that do not respond to these treatments.
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Calluses
Calluses are caused by accumulation of dead skin cells. These hardened areas of the skin are your body's way of protecting itself from pressure and friction. Normal areas that may develop calluses are the heel, inside the big toe, and on the ball of the foot. Calluses develop due to excessive pressure on certain areas of the foot.
Common issues that lead to callus formation are obesity, flat feet, high arched feet, and an abnormal walk cycle, to name a few. Use of orthotics is highly recommended to alleviate the pressure that causes calluses. It also allows any calluses already present to heal. Speak to your physician for more treatment options.
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Bunions
Bunions and hallux limitus are the two most common causes of big toe pain. Normally, the big toe bends about 60-75 degrees when you walk. If your foot is very flat, if your toe or foot has been injured, if you are getting older, or if you wear shoes that are too tight, too much pressure may be placed on the joint, limiting its motion. Over time, the joint can become painful, stiff, deformed, and eventually destroyed.
Stiffness of the big toe joint is known as hallux limitus; "hallux" means "big toe," and "limitus" means "limited." Hallux limitus is usually accompanied by pain and arthritis in the big toe joint. It is a degenerative condition, meaning it gets worse over time. If hallux limitus is left untreated, the joint may eventually fuse, losing all motion ("hallux rigidus"). Early detection and treatment is key to limiting damage.
Many people with hallux limitus develop a deformity known as a bunion. A bunion occurs when pressure on the big toe gradually forces it to bend toward or under the second toe, and a bump forms on top of the joint.
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Hammertoes
Hammertoes are an abnormal "V"-shaped bending of the little toes. Caused by stiffened tendons, hammertoes often form because of a muscle imbalance, arthritis, a hereditary condition, an injury, or tight shoes that squeeze the toes. They may be flexible (the toes can still be moved at the damaged joint) or rigid (the toes are immobile). Many people with hammertoes develop swelling, redness, stiffness, or painful corns or calluses as the toes rub against the inside of the shoes.
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Toenail Fungal Infection
 At Manhattan Footcare, we are proud to offer the PinPointe™ Laser for treatment of toenail fungal infections. This FDA-approved treatment transmits laser energy that passes through the toenail to kill the fungus underneath through a simple, minimally invasive procedure that takes less than 30 minutes to perform. The PinPointe laser targets the pathogens that cause toenail fungus, which treats not only the current infection, but also helps prevent them in the future. Most patients experience no pain from this procedure and are able to enjoy effective, long-lasting results.
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