Numbness & tingling –
Morton’s neuroma
No numbness & tingling –
Metatarsalgia
Plantar fasciitis
Iselin’s disease
(<16-year-old)
1. Iselin’s disease (<16-year-old)
Intro: Iselin’s disease involves irritation of the growth plate on the outer side of the midfoot, where a bony protuberance may be felt. This is often a due to overuse especially in young athletes.
Symptoms: Pain on the outer side of the midfoot especially on activity use.
Treatment: Rest, ice, activity modification, and physical therapy. Symptoms typically resolve once growth plate closes.
2. Plantar fasciitis
Intro: The planta fascia is a fibrous band of tissue that supports the arch of the foot. Irritation occurs due to overuse, tightness of the fascia and calf/Achilles, or being overweight.
Symptoms: Heel pain especially when first putting weight, which may getter after walking more.
Treatment: Ice, physical therapy to stretch the plantar fascia and Achilles tendon, and medication. Use of orthotics or use of a night splint at night may help promote stretching of the fascia. A steroid injection for pain relief or regenerative treatment such as plasma rich platelet (PRP) injection to promote healing is sometimes considered. In refractory cases, surgeries such a release of the fascia (fasciotomy) may be considered.
3. Ball of foot pain
A. Numbness & tingling – Morton’s neuroma
Intro: Morton’s neuroma is a condition involving irritation to the nerve between the toes of the foot.
Symptoms: Pain on the bottom of the foot especially when putting weight and discomfort when squeezing the toes together.
Treatment: Wearing wider shoes with a hard sole, use of a metatarsal pad, and medication. A steroid injection may help relief symptoms. In refractory cases, neurectomy (nerve removal) surgery may be considered.
B. No numbness & tingling – Metatarsalgia
Intro: Metatarsalgia involves irritation to the ball of the foot. Tight shoes, high foot arch, tight Achilles tendon, and other foot deformities may lead to this condition.
Symptoms: Pain when putting weight.
Treatment: Proper shoe fitting, metatarsal pads, and stretching.