Some Foot Trouble

Posted Friday, May 23, 2008

From: http://www.podiatrychannel.com/mortonneuroma/index.shtml

Morton's Neuroma is an enlarged nerve that usually occurs in the third interspace, which is between the third and fourth toes (see image below). To understand this further, it may be helpful to look at the anatomy of the foot.

Problems often develop in this area because part of the lateral plantar nerve combines with part of the medial plantar nerve here. When the two nerves combine, they are typically larger in diameter than those going to the other toes. Also, the nerve lies in subcutaneous tissue, just above the fat pad of the foot, close to an artery and vein.

Above the nerve is a structure called the deep transverse metatarsal ligament. This ligament is very strong, holds the metatarsal bones together, and creates the ceiling of the nerve compartment. With each step, the ground pushes up on the enlarged nerve and the deep transverse metatarsal ligament pushes down. This causes compression in a confined space.

The reason the nerve enlarges has not been determined. Flatfeet can cause the nerve to be pulled toward the middle (medially) more than normal, which can cause irritation and possibly enlargement of the nerve. The syndrome is more common in women than men, possibly because women wear confining shoes more often. High heels cause more weight to be transferred to the front of the foot and tight toe boxes create lateral compression. As a result, there is more force being applied in the area and the nerve compartment is squeezed on all sides. Under such conditions, even a minimal enlargement in the nerve can elicit pain.

Plantar Wart

from:
http://www.mayoclinic.com/health/plantar-warts/DS00509/DSECTION=8

Plantar warts usually go away on their own, but most people would rather treat them than wait for them to disappear. Unless you have an impaired immune system or diabetes or are pregnant, there's no reason you can't treat warts with over-the-counter remedies. But you may wish to consult your doctor for help. He or she may suggest a combination of over-the-counter and office treatments for plantar warts.

No wart treatment works 100 percent of the time. In general, your doctor will recommend the least painful — and least destructive — methods first, especially for children.

Common treatments for simple plantar warts
Your doctor may suggest trying these common treatments one at a time or in combination:

• Salicylic acid. Wart medications and patches are available at drugstores. To treat plantar warts, you'll need a 40 percent salicylic acid solution or patch (Curad Mediplast, Dr. Scholl's Clear Away Plantar, others), which peels off the infected skin a little bit at a time. Apply the solution once or twice each day, being careful to avoid healthy skin, which can become irritated from the acid. In between applications, pare away the dead skin and wart tissue using a pumice stone or emery board. You may need to repeat this process for up to three or four weeks to completely eliminate warts.
• Duct tape. In a well-publicized 2002 study, duct tape wiped out more warts than freezing (cryotherapy) did. Study participants who used "duct tape therapy" covered their warts in duct tape for six days, then soaked their warts in water, and gently rubbed warts with an emery board or pumice stone. They repeated this process for up to two months or until their warts went away. Researchers hypothesize that this unconventional therapy may work by irritating warts and the surrounding skin, prompting the body's immune system to attack. Today, duct tape is commonly used to treat warts, especially for children who may find freezing painful or scary. It's often combined with salicylic acid.
• Freezing (cryotherapy). Freezing is one of the most common treatments for plantar warts and is usually effective, but may require multiple trips to your doctor every two to four weeks. Your doctor can apply liquid nitrogen with a spray canister or cotton-tipped applicator. The chemical causes a blister to form around your wart, and the dead tissue sloughs off within a week or so. Freezing isn't commonly used in young children because it can be painful.
• Cantharidin. Doctors and healers have used cantharidin — a substance extracted from the blister beetle — to treat warts for centuries. Today, this therapy is sometimes paired with salicylic acid. Your doctor paints this beetle juice onto your wart and covers it with clear tape. The application is painless, but it causes the skin under the wart to blister, lifting the wart off the skin. Your doctor can then clip away the dead part of the wart in about a week. However, some doctors are hesitant to use cantharidin because it's not approved by the Food and Drug Administration for the treatment of warts.