A neuroma is a thickening of nerve tissue that can develop in various parts of your body. In the foot, the most common occurring neuroma develops at the base of the third and fourth toes. This condition is referred to as Morton's neuroma.

There are typically no physical signs of Morton's neuroma, such as a lump or a knot. Instead, symptoms may include:

• A sharp, achy or burning pain in the ball of your foot
• Numbness, tingling, or cramping in the toes or forefoot
• Feeling as if you're standing on a pebble in your shoe

While the exact cause of Morton's neuroma is unknown, the growth of the neuroma seems to occur in response to injury, pressure or irritation to one of the nerves that lead to the toes. People with certain foot deformities - bunions, hammertoes and flatfeet- are at higher risk for developing a neuroma. Women are also more likely to develop this condition as wearing high-heels or narrow-toed shoes can increase pressure on the toes. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running.

Morton's neuroma can make walking and performing normal activities difficult and painful. Treatment options vary with the severity of each neuroma, and identifying the neuroma in its earliest stage of development is important to avoid more invasive treatments or surgical correction. Left untreated, neuromas tend to worsen, so it's always best to visit our Brooklyn NY office at the first sign of pain.

Early treatments aim to relieve or reduce pressure on the area around the affected toes. Depending on the severity of your neuroma, a podiatrist may recommend:

• Modifications to footwear. Wide-toed shoes relieve pressure on the neuroma.
• Shoe inserts or padding to provide support for the arch of the foot, which removes pressure from the nerve.
• Anti-inflammatory medications can help ease any pain and inflammation. Ask your doctor first.
• Icing to reduce inflammation.
• Rest to lessen repetitive pressure on the neuroma.

In the most severe cases, surgery may be recommended for patients who do not respond to conservative treatments. Dr. Perlstein can help you determine the best approach for your specific condition.

During pregnancy, it's not uncommon for women to experience an array of aches and pains all over the body. Among these complaints are tired, swollen, achy feet- a common and painful symptom experienced by mothers-to-be during their nine months of pregnancy.

One of the most common foot problems that occur during pregnancy is swelling, or edema, which results from the extra accumulation of blood. The natural weight gain and enlarging uterus puts pressure on the veins that lead to the legs, causing circulation to slow down and increasing fluid retention. The legs and feet may become swollen, making shoes tight, and in some cases causing pain and discomfort. Slight swelling during pregnancy is normal and usually subsides after giving birth. Women should pay close attention to edema symptoms. Swelling to the face or a sudden onset of swelling could be a sign of a more serious condition called preeclampsia and should be reported immediately.

Another troubling foot problem that can occur during pregnancy is over-pronation (flat feet) which is caused when a person's arch flattens out upon weight bearing causing the feet to turn in abnormally. This condition develops when the dense band of tissue in the arch of the foot called the plantar fascia becomes strained and inflamed due to increased flattening of the feet. Over-pronation is common in pregnancy due to the increased weight gain which stresses the feet and flattens the arches. Walking can become very painful, and women may experience increased discomfort and strain on the feet, calves and back.

There are various remedies available to help minimize and alleviate foot pain during pregnancy.

• Take short breaks during the day and elevate your feet to relieve pressure and swelling.
• Drink plenty of water.
• Wear shoes that are soft, comfortable and give your feet room to move.
• Wear seamless socks that do not constrict circulation.
• Exercise or walk regularly to promote overall health.
• Stretch legs frequently and avoid crossing your legs when sitting.
• To prevent arch pain, stretch daily, avoid going barefoot and wear supportive low-heeled shoes.

When foot pain persists, visit Dr. Perlstein. We'll work with you to find the best treatments for your foot pain. Pregnancy and pending motherhood should be a pleasant, enjoyable experience. Understanding the causes of foot pain and learning easy home remedies can help women step more comfortably throughout these special nine months.

Metatarsalgia denotes a common foot condition characterized by pain and inflammation of the joints and bones of the ball of the foot - the area just before the toes, also called the metatarsal region.

Symptoms of metatarsalgia can develop suddenly, especially after an increase in exercise or high-impact activities, but normally the problems develop over time. Common symptoms of metatarsalgia include:

• Sharp, aching or burning pain in the ball of your foot -- the part of the sole just behind the toes
• Pain that intensifies when you stand, walk or run
• Pain that radiates from the balls of the feet into the toes
• Numbness or tingling in the toes
• A feeling in your feet as if you are walking with a pebble in your shoe
• Pain that increases when walking barefoot

Sometimes a single factor can trigger metatarsalgia. More often, multiple factors contribute to the pain, including:

• Over-training or Over-activity. Extensive training and high-impact sports, especially running, places an abnormal amount of stress on the balls of the feet, causing irritation, inflammation and pain.
• Other foot disorders. High arches, hammertoes, bunions, stress fractures and Morton's neuroma can all trigger metatarsalgia symptoms.
• Poor-fitting footwear. High heels, narrow-toed shoes and shoes without adequate padding can all contribute to metatarsal problems.
• Excess weight. Extra weight places excess pressure on your metatarsals.
• Aging. The fat pads on the metatarsals thin out as a person ages, diminishing the ability of the metatarsal bones to protect themselves.

Although generally not serious, metatarsalgia can disrupt your day to day activities, and when left untreated can lead to additional pain in your unaffected foot, back or hips. Treatment to eliminate metatarsalgia symptoms can be as simple as resting, icing the affected area and wearing proper-fitting shoes to significantly reduce swelling and ease pain.

When conservative treatments aren't affective and pain persists, visit Dr. Perlstein, for a full exam and a proper diagnosis. In most cases, metatarsalgia can be treated non-surgically. An experienced podiatrist at our Brooklyn NY office may prescribe specially-designed orthotics or shock-absorbing insoles and arch supports to prevent and minimize future problems with metatarsalgia.

Ingrown toenails, also known as onychocryptosis, can be embarrassing, annoying and painful. This common condition occurs when the surrounding skin on one or both sides of the nail grows over the edges of the nail, or when the nail itself penetrates the skin. As the nail digs into the skin, redness, swelling, and pain are often the result.

People develop ingrown toenails for various reasons. Poor nail-trimming is the most common cause, as this encourages the skin to fold over the nail. Other causes include trauma, such as stubbing a toe, or skin conditions, such as fungal infections or nails that are simply too large. In some cases, the condition may even be inherited. Poor-fitting shoes generally aggravate the condition, making it worse.

Many cases of ingrown toenails may be prevented by:

• Wearing well-fitted shoes and socks
• Protecting feet from trauma when possible
• Trimming toenails straight across and avoiding repeated trimming of the nail borders
• Keeping feet clean and dry to prevent infection

If an infection is not suspected of your ingrown, it can usually be safely treated from home by soaking your foot in warm water. Avoid "bathroom surgery" and repeated cutting of the nail as this will only make the condition worse.

When attempts to reduce your symptoms from home fail, or when pain, inflammation, swelling or discharge accompany your ingrown, the toenail is most likely infected and should be treated by a podiatrist at our Brooklyn NY office. People with diabetes, nerve damage or poor circulation should always seek care immediately if an ingrown nail is detected, regardless of the severity.

A podiatrist can examine the affected toe and determine the best treatment for your condition. For an infection, an antibiotic may be prescribed. Other treatments may involve trimming or removing the infected nail with a minor in-office surgical procedure.

Ingrown toenails may be annoying, but rest assured that they can easily be prevented and treated with the help of your podiatrist. If you think you have an ingrown toenail, visit Dr. Perlstein for quick and easy treatment.

A hammertoe is one of the most common toe conditions, usually stemming from muscle imbalance in which the joints of the second, third, fourth or fifth toe are bent into a contracted, claw-like position. In the early stages, hammertoes are flexible and can be corrected with simple conservative measures, but if left untreated, they can become fixed and require surgery.

The most common cause of hammertoe is a muscle imbalance. Tight-fitting and high-heeled shoes often aggravate the condition, crowding your toes forward. A hammertoe can also be the result of injury in which you break or jam the toe, or from conditions like arthritis or stroke that affect nerves and muscles. In some cases, hammertoes may even be inherited.

Because of their clenched, claw-like appearance, hammertoes will generally be visibly present. Other signs and symptoms include:

• Difficult or painful motion of a toe joint
• Redness or swelling at a toe joint
• Development of calluses and corns
• Open sores in severe cases

The foot and ankle professionals at our Brooklyn office recommend the following for preventing and reducing the symptoms associated with hammertoe:

• Wear comfortable, proper-fitting shoes that provide support and allow enough room for your toes
• Avoid high-heeled or narrow-toed shoes
• Stretch your toe muscles to relieve pressure and pain
• Apply splints, cushions or pads to relieve pressure
• Moisturize with cream to keep the skin soft

Generally, a modification of footwear will reduce the symptoms associated with hammertoe. Other non-surgical treatment includes padding to shield corns and calluses and orthotic devices that are placed in the shoe to help control muscle imbalance. Dr. Perlstein can help you determine the best treatment for your symptoms. Severe cases that don't respond to conservative measures may require surgery to restore your toe's flexibility and eliminate the pressure.

Hammertoes are progressive - they don't go away by themselves and the condition usually gets worse over time. Once a podiatrist at Dr. Perlstein has evaluated your hammertoe, a treatment plan can be developed that is suited to your needs.