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Foot Problems
November 2003

Q. I have had what I've always thought of as callouses on the ball of my feet--two on each foot--one under the big toe and one under the little toe. I developed another a few years ago on the end of my middle toe. They are extremely painful, even if just brushed by accident. These have "cores" that I have to remove frequently or it is like walking on thumb tacks.

I am high arched, so it is impossible to walk without putting pressure on these sore spots. I had surgery to straighten the bones many years ago. It did not help and my feet have gotten much worse. I recently went to another podiatrist who took one look at them and told me they were plugged sweat glands and short of orthotics there was no treatment.

I got the orthotics and they help somewhat but I still have very sore feet all the time and frequently have shooting nerve pain in these areas. I had never heard of plugged or clogged sweat glands on feet. Is there a name for this condition so that I could research further?

A. You describe two problems in the feet, the thickened areas, and the high arches. High arches are common and do not always cause pain or other foot problems, but they may require treatment. The usual approach, as you have done, is to try orthotics, basically a custom arch support to put the foot in an optimal position and relieve concentrated areas of stress. The callouses usually result from high pressure areas. Skin conditions can certainly affect the foot, and this could be the case in addition to the anatomical considerations. Certain types of eczema are common on the feet and can resemble plugged sweat glands. Your family doctor or a dermatologist can likely help in this evaluation.

Another common condition affecting the feet is nerve irritation such as may occur from a nerve originating in the back or lower in the leg. Other more general health concerns such as diabetes or arthritis may manifest primarily as pain in the feet. Again, your family doctor would be a good start to sort out these possibilities.

http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=178&topcategory=Foot

http://www.nia.nih.gov/health/agepages/footcare.htm

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