I've Got a Tumor...I Just Know It!

Several times a day I will see patients that are convinced they have some sort of soft tissue mass or tumor on the bottom of their foot.  Usually their pain is under their 2nd or 3rd toe and it feels like they are walking on a mass or as I call it a "wad".  Complaints range from stabbing, sharp pain to numbness in the toes to an overall ache across the ball of the foot.  Often this is followed by pain across the top of the arch or outside of foot.  So is this a tumor?  Rarely.

Pain and swelling under the 2nd and 3rd toes is often what is called capsulitis.  This is the swelling of the capsule or balloon that surroundings your joints.  All of our joints have a capsule who's job is to keep joint fluid in place so that the joint moves smoothly.  But when this capsule takes too much pressure, it swells causing pain and the feeling of a mass or tumor on the bottom of the foot.

So how does this happen?  Here's the most common set up:
You have a bunion.  This causes a shift of the weight when you push off from your big toe to your 2nd toe because the 1st MPJ isn't working correctly.  You wear flip flops all summer and force your 1st and 2nd toes to squeeze like crazy to keep the shoe on and now you are really pushing off your 2nd toe joint.  Now the swelling begins and all shoes hurt, so does walking barefoot.  You look at the bottom of your foot and holy smokes....there is a localized pocket of swelling under your toes!  Now it hurts to even bend your toe.  Sound familiar?

Other things that can cause this to happen:
* 2nd or 3rd metatarsals that are much longer than normal
* 2nd toe that curls up and almost (or does) cross over the big toe
* plantar plate injuries that allow the 2nd toe to dislocate
* severe arthritis in the big toe joint
* actual tumors

So what is the best way to get rid of this pain?  First, ice. This will reduce some of the swelling and improve discomfort.  Stiffer soled shoes that do not allow the toe area to bend very much, this allows rest.  Actual rest is a good too.

But the best option is to have your foot evaluated by a member of the FAANT team to explain exactly why you get this pain and how to prevent it from coming back.