Finding a lump under your foot may be worrisome, but should you be concerned about it? It’s not uncommon to find all kinds of skin changes, lumps, and bumps in various places on our bodies, especially as we age. Some are harmless and benign, while others should be evaluated and treated by a podiatrist.
1. Calluses
Calluses are among the most common skin conditions we see in our office. Calluses are a thickening of the skin that occur in response to too much pressure and are often found on the bottom of the feet. While they are benign, they can cause pain when walking or running.
Causes
Some of the ways calluses develop are:
- Wearing shoes that increase pressure or friction on the bottom of the foot.
- Wearing shoes without socks.
- Having another foot condition such as hammertoe which can put more pressure on your foot.
- Family history — you can inherit a tendency to develop calluses on the bottom of your foot.
Treatment of Calluses
Removing calluses is necessary for comfort and essential if you have a condition like diabetes. Patients with diabetes or another circulatory problem can develop wounds if calluses aren’t removed.
Prevention of Calluses
- Wear shoes that fit well and provide plenty of room in the toe box. Shoes should have a heel of one inch or less to reduce pressure on the ball of the foot.
- Patients with diabetes may need special diabetic shoes and inserts designed to prevent friction.
- Wear socks that wick away moisture.
- Never wear closed-toed shoes without socks.
- Pads and cushions can help protect the area that tends to develop a callus
- Custom orthotics – if improper foot mechanics are the culprit behind callus development, getting fit for custom orthotics may be the best solution.
2. Corns
Corns are another common type of hardened skin. They’re similar to calluses, but smaller, deeper, and more painful. While calluses typically spread out over a larger area, corns have a hard center surrounded by inflamed skin and can feel like you're stepping on a small stone.
Corns usually form on the tops or sides of toes, but they can also appear on the ball of the foot.
What is the key difference between corns and calluses? Corns have a cone-shaped core that presses into deeper layers of skin, which is why they tend to hurt more than calluses.
Cause of Corns
They develop from repeated pressure and friction, often from shoes that don't fit properly.
Treatment of Corns
Never try to cut or shave a corn yourself, and don’t allow anyone to do this during a pedicure — it can lead to infection. A podiatrist can safely remove them and identify the underlying cause to prevent recurrence.
Prevention of Corns
In addition to following the prevention strategies for calluses, your podiatrist may also recommend:
- Using toe sleeves, toe spacers, or protective pads to reduce rubbing.
- Addressing toe deformities like hammertoes or curled toes.
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3. Plantar Warts
3. Plantar WartsPlantar warts are common in adults and children. They are caused by the Human Papilloma Virus (HPV). They can cause sharp, burning pain on the bottom of the feet. They can spread to other parts of the body and to other people, and can cause real discomfort, so they should be removed.
Causes of Plantar Warts
- Walking barefoot where the virus thrives such as pools, locker rooms, and yoga studios.
- Sharing towels, razors, and other personal items.
- Having cuts and scrapes on the feet for easy virus entry
- People with a weakened immune system can more easily develop HPV
Treatment of Plantar Warts
Plantar warts can be treated through a variety of methods including:
- Chemical application (cantharone)
- Freezing
- Surgical removal
- Immune therapy (Swift) – our office uses this newer treatment which has a much lower recurrence rate than other modalities.
Prevention of Plantar Warts
- Avoid direct contact with warts from other people or other parts of the body.
- Don't share foot implements such as clippers with someone who has warts, unless you sterilize them with alcohol first.
- Avoid walking barefoot, except on sandy beaches. Wear flip flops in locker rooms and public showers.
4. Plantar fibroma
Plantar fibromas are benign or non-cancerous growths found in the plantar fascia, the ligament that runs along the bottom of your foot. Fibromas can be painful and often get larger without treatment.
Causes
There’s no definitive cause of plantar fibroma, but they’re more likely to occur in men, in people between 30 and 50, in people of European descent, and in those with certain medical conditions such as diabetes and epilepsy.
Treatment of Plantar Fibromas
- Cortisone to shrink it and relieve the pain.
- Custom orthotics can help remove pressure on the fibroma.
- Surgery is done when none of the other treatments help. Unfortunately, there is a high rate of recurrence.
Prevention
Unfortunately, there's no known way to prevent a plantar fibroma. Since genetics appear to play a significant role, many people develop them without any obvious cause. While wearing supportive shoes and avoiding repeated foot injuries are good for your overall foot health, they haven't been proven to prevent plantar fibromas.
Learn more about plantar fibromas here!
5. Ganglion Cyst
Often confused with fibromas, ganglion cysts found on the bottom of the foot are fluid-filled lumps appearing along tendons and joints. The pain is caused by pressure from shoes, but tingling and burning can develop when the cyst is found near a nerve.
Causes of Ganglion Cysts
Ganglion cysts are most likely caused by:
- Trauma to the foot
- Constant pressure and stress on the foot
- Irritation to the tendons and joints.
- Women are more at risk than men
Treatment for Ganglion Cysts
- If you aren’t feeling any pain, no treatment is necessary.
- Draining the cyst
- Cortisone
- Surgical removal is the only method to prevent recurrence
Preventing A Ganglion Cyst
Unfortunately, there is no proven way to prevent a ganglion cyst. While wearing supportive shoes, avoiding repetitive stress, and treating foot injuries promptly may help reduce stress on your joints and tendons, ganglion cysts can still develop without any obvious cause.
Learn more about ganglion cysts here!
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6. Morton’s neuroma
6. Morton’s neuromaMorton’s neuroma is a benign growth of nerves that develop between the 3rd and 4th toes. In the early stages of this condition, many people say they notice a lump or pebble under their foot. They may also feel some pain that comes and goes in the ball of the foot. But as it progresses the pain becomes more constant making it difficult to walk or participate in sports.
Causes and Risk Factors for Morton’s Neuroma
- Wearing high heels and shoes that pinch the toes
- Other foot conditions such as flat feet, hammertoes, and bunions
- Trauma to the foot
- Runners or other active people
Treatment of Morton’s Neuroma
- Wearing shoes with a wider toe box and flatter heel.
- Custom orthotics and a metatarsal pad to help remove pressure on the ball of the foot
- Guided ultrasound injections of alcohol to shrink the neuroma
- MLS laser therapy to reduce pain and inflammation.
Surgical removal if all conservative treatments fail.
Prevention of Morton’s neuroma
You can slow down the development of Morton’s neuroma and prevent symptoms from worsening by minimizing pressure on the nerves in the ball of your foot.
- Wearing shoes that are less than one inch in height have a wide toe box to prevent toes from getting cramped.
- Wear athletic shoes with plenty of padding to cushion the balls of your feet.
- Try lower-impact exercises, or work with a coach or trainer to tweak activities to put less pressure on your feet.
- Use a metatarsal pad to redistribute the pressure away from the nerve.
- Make sure to wear custom orthotics all the time if you have them.
Learn more about Morton's neuroma here!
7. Bursitis of the Foot
Bursitis can also cause lumps on the bottom of the foot. Bursae are small, fluid-filled sacs that cushion the bones, tendons, and muscles around your joints. When these become inflamed they can swell and create a noticeable bump. Bursitis on the bottom of the foot is most commonly found under the heel or the ball of the foot. It feels soft to touch and may be warm or tender. Other symptoms are swelling and redness.
Causes of Bursitis of the Foot
- Repetitive use such as participation in athletics or walking and standing for long periods of time i.e. on the job
- Wearing shoes that are too tight
- Abnormal foot and gait abnormalities such as flat feet, bunions, and overpronation
Treatment of Bursitis
To reduce pain:
- Wear shoes with a wider toe box and lower heel to reduce pressure on the ball of the foot.
- Rest, ice, and anti-inflammatory medications can also help in mild cases.
- Padding or orthotics to align your feet to relieve the pain
- Cortisone injection to reduce inflammation.
- Surgery may be required if all conservative treatments fail.
Prevention of Bursitis of the Foot
- Change up your athletic pursuits
- Choose supportive shoes with a wider toe box and low heel.
- Wear custom orthotics all the time if you have abnormal foot mechanics
8. Foreign Body
Sometimes what feels like a lump is your body's reaction to a foreign object embedded in your foot — like a splinter, piece of glass, or thorn. I’ve even found dog and cat hairs in patients’ feet that are causing the problem.
Even if the object was removed or broke off, your body may form a small nodule or granuloma around it. The remaining portion of the foreign body will need to be removed by a podiatrist.
These lumps can be painful and may become red or swollen if infected. An X-ray or ultrasound can help identify the foreign material, and removal is usually straightforward.
Causes
Foreign bodies most often get embedded in the foot through:
- Walking barefoot outdoors, in the garage, or in unfinished spaces where sharp debris is common
- Stepping on glass, splinters, thorns, or small metal fragments
- Pet hair or fibers working into the skin through a small cut or crack
- Cuts, scrapes, or other breaks in the skin that let debris enter
Treatment of Foreign Bodies
While many people attempt to remove a foreign body themselves, this is seldom a good idea if you want to avoid infection. Sometimes a foreign body works its way out on its own, but most often it needs to be removed by a podiatrist.
Prevention
Wearing appropriate footwear is the most effective way to prevent a foreign body from becoming embedded in your foot.
People with diabetes need to wear footwear at all times, even indoors, since nerve damage can make it hard to feel an injury until it's already caused a problem, such as ulcer formation.
When to See a Podiatrist for Bottom of Foot Lumps
While most foot lumps are benign, certain warning signs should never be ignored:
- A lump that grows rapidly or changes in appearance
- Severe pain that interferes with walking or daily activities
- Redness, warmth, pus, or drainage are possible signs of infection
- A lump that appears after an injury or trauma
- Numbness, weakness, or loss of sensation in the foot
- A firm, irregular lump that doesn't move when pressed — while rare, this could indicate a more serious condition
If you experience any of these symptoms, schedule an appointment with a podiatrist as soon as possible.
