Bunions If you have a bunion, you know it can be a painful enlargement at the joint of the big toe. The skin over the joint becomes swollen and is often quite tender. Bunions can be inherited as a family trait; can develop with no recognizable cause or can be caused by shoes that fit poorly. An important part of treatment is wearing shoes that fit properly and do not cause pressure areas. This often alleviates the pain. In severe cases, bunions can be disabling. Conservative options may be available in addition to surgery. Several types of surgery are available that may relieve pain and improve the appearance of the foot. Surgery is usually done to relieve pain and is not meant for cosmetic purposes. Heel Pain Heel pain is extremely common. It often begins without injury and is felt under the heel, usually while standing or walking. It is usually worst when arising out of bed. Inflammation of the connective tissue on the sole of the foot (plantar fascia) where it attaches to the heel bone is the most common cause of pain. It is often associated with a bony protrusion (heel spur) seen on X-ray studies. Multiple treatments exist to address pain which include stretching exercises, medication to reduce swelling of the soft tissues in your foot, and most importantly custom orthotics. If pain continues, steroid injections, walking casts, night splints, and athletic taping methods may be used. Only in the most troubling and prolonged cases is surgery recommended. Morton’s Neuroma Morton's neuroma is caused by a nerve being pinched. This pinching usually results in pain between the third and fourth toes. Tight shoes can squeeze foot bones together. The nerve responds by forming a neuroma, a build up of extra tissue in the nerve. The neuroma results in pain, that may radiate into the toes. Treatment usually involves wearing wider shoes and taking oral medications to decrease the swelling around the nerve. A pad on the sole of the foot to spread the bones is often helpful. An injection of cortisone around the nerve may also be recommended. If your difficulty continues, surgery to remove the neuroma may be suggested.