We all wear shoes and as a result even minor changes to the shape of our feet can have quite dramatic effects on our quality of life if shoes become uncomfortable. If these symptoms persist, despite using common sense in your selection of footwear, then you may need to seek professional advice.

The most common painful foot deformity affects the big toe and is known as Bunion (please see ‘Bunion and Big Toe Pain’ section). Lesser (small) toe deformities are also common and can occur alone or associated with deformities of the big toe. The common terms used are ‘Hammer’, ‘Claw’ and ‘Mallet’ toe deformities. These deformities are more common in women, particularly after the age of 40, but can present in childhood as ‘curly toes‘. In severity they range from mild and easily correctable, to very rigid fixed contractures. The most common complaints are altered appearance and painful callosity formation from rubbing in the shoes. The treatment depends upon the type and severity of deformity and in the initial stages involves measures such as strapping of the toes, toe protectors and modification of footwear.  If these measures fail then you may require an operation. Operations differ between children and adults, and generally soft tissue procedures are preferred where possible in children, or when the joints are still flexible.

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Lumps and bumps on the top of the foot are quite common, and the commonest type is the ‘ganglion’. These are rubbery lumps, which vary in size from a very small pea to the size of a golf ball. Ganglia usually grow and cause discomfort on top of the foot and difficulty with footwear. They occur spontaneously and occasionally disappear as quickly as they arrive. Small ganglia may be ignored. If the swelling is large and causing symptoms, then needle aspiration of the ganglion can be performed, but there is a high rate of recurrence. Alternatively, exploration and excision of the swelling can be carried out, but carries a rate of recurrence of 20-30%.

Other causes of swellings in the foot include synovitis, trauma, infection among others, and usually require investigation prior to diagnosis. If you have a lump which has grown rapidly, and is painful day and night, you should contact your doctor urgently.

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