What Causes Lumps in the Foot?

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Lumps on the foot can be a source of discomfort, concern, and, at times, significant pain. While some lumps are harmless, others may indicate underlying conditions that require professional intervention.

The foot’s complex anatomy, which includes bones, muscles, nerves, and connective tissues, can give rise to various types of lumps, each with its own causes and symptoms. Early diagnosis and treatment are key to preventing potential complications ensuring patients maintain mobility and comfort.

This article will explore the common causes of foot lumps, along with diagnostic and treatment options available for podiatrists.

Common Lumps in the Foot

Fibroma

A fibroma is a benign fibrous tissue growth that can form on the plantar fascia, the band of tissue running along the sole. Plantar fibromas feel firm and are usually located on the arch of the foot.

While often painless, larger fibromas or those that press on surrounding structures can cause discomfort, especially when walking. Treatment may involve orthotics to reduce pressure, corticosteroid injections to shrink the lump, or surgery in persistent cases.

Epidermal Inclusion Cyst

Epidermal inclusion cysts are small, round lumps that form under the skin when keratin, a protein found in skin cells, becomes trapped. These cysts may appear on any part of the foot and are generally slow-growing, non-painful, and mobile.

If they become infected, they can swell, turn red, and cause pain. Most cysts can be managed with observation or drained if they grow too large or become uncomfortable.

Rheumatoid Nodule

People with rheumatoid arthritis may develop rheumatoid nodules on their feet, which are firm, painless lumps that form under the skin, often near joints. These nodules vary in size and may feel tender during rheumatoid arthritis flare-ups.

Treatment typically focuses on managing the underlying rheumatoid arthritis rather than the nodules themselves, as they often diminish with effective systemic treatment.

Gouty Nodule (Tophi)

Gout is a form of arthritis that leads to the accumulation of uric acid crystals, particularly in the joints. In chronic cases, these crystals can form hard nodules called tophi, which often appear on the toes or the top of the foot. Tophi are firm and may become tender during a gout flare-up.

Treatment includes lifestyle modifications, medications to lower uric acid levels, and sometimes surgical removal if the tophi are especially large or painful.

Lipoma

Lipomas are soft, fatty lumps that develop under the skin and are generally non-painful and movable. They can occur on any part of the body, including the foot. Lipomas are typically benign and rarely require treatment unless they cause discomfort or limit movement.

When treatment is necessary, surgical excision is the most common approach.

Ganglion Cyst

A ganglion cyst is a fluid-filled sac that commonly appears near joints and tendons, often on the top of the foot or around the ankle. These cysts are usually round and firm and may fluctuate in size.

While generally painless, ganglion cysts can cause discomfort if they press against a nerve or interfere with joint movement. Treatment can involve aspiration (draining the fluid) or surgical removal if the cysts are recurrent or painful.

Wart

Warts are caused by the human papillomavirus (HPV) and present as small, rough lumps that can develop anywhere on the foot, particularly in weight-bearing areas like the sole. Warts on the foot, also known as plantar warts, can grow inward due to pressure, resulting in discomfort when walking.

Treatments include over-the-counter remedies, cryotherapy (freezing), or surgical removal.

Abscess

An abscess in the foot is a painful, swollen lump filled with pus, usually caused by bacterial infection. Abscesses often result from puncture wounds or other skin injuries. They can be red, warm, and tender to the touch.

Immediate treatment is required, typically involving drainage of the abscess and antibiotics to clear the infection.

Corn

Corns are hardened layers of skin that develop due to excessive pressure or friction, often from ill-fitting shoes. They commonly appear on the tops or sides of toes and may feel like small, firm lumps.

Though corns on the feet are not typically serious, they can cause pain when pressed. Treatment includes wearing properly fitting shoes, using protective padding, and, in some cases, removal by a healthcare provider.

Hematoma

A hematoma is a localized collection of blood outside of blood vessels, typically caused by trauma or injury to the foot. When blood vessels break, blood leaks into the surrounding tissues, leading to swelling and the formation of a lump.

Hematomas in the foot can result from impacts, falls, or even repetitive stress injuries. Most resolve on their own with time, but treatment can help alleviate discomfort and speed up recovery.

Bone Spur

Bone spurs, or osteophytes, are bony projections that develop along the edges of bones, often as a result of prolonged stress or pressure. In the foot, bone spurs commonly form on the heel (heel spurs) or around joints where ligaments and tendons attach to the bone.

They are frequently associated with conditions like arthritis or plantar fasciitis, which create inflammation and stimulate extra bone growth.

Treatment for pain caused by bone spurs includes footwear modifications, physical therapy, or medications. In severe cases where the bone spur continues to cause significant discomfort or limits mobility, surgical removal may be necessary.

Muscle Hernia

Muscle hernias occur when muscle tissue protrudes through a tear or weak spot in the surrounding fascia—the connective tissue that encloses the muscle. In the foot and lower leg, muscle hernias are most often seen in the anterior compartment muscles, and they typically result from trauma, overuse, or a congenital weakness in the fascia.

Though they are relatively rare, muscle hernias can cause a visible lump and various symptoms, especially during physical activity. The treatment approach for muscle hernias depends on the severity of symptoms but largely revolves around physical therapy and activity modification.

Morton’s Neuroma

Morton’s neuroma is a painful condition that affects the ball of the foot, most commonly between the third and fourth toes. It occurs when the tissue around a nerve leading to the toes thickens, often due to repetitive pressure or irritation.

This can lead to inflammation and enlargement of the nerve, causing sharp or burning pain. 

Morton’s neuroma is particularly common in individuals who wear tight, narrow shoes or engage in high-impact activities like running. Any treatment for Morton’s neuroma focuses on reducing pressure on the nerve.

Plantar Fibromatosis

Plantar fibromatosis, also known as Ledderhose disease, is a condition where benign, fibrous nodules develop on the plantar fascia—the thick band of tissue running along the sole of the foot. These nodules usually form in the arch of the foot and can vary in size and number.

While the nodules are non-cancerous, they can cause discomfort, especially when standing or walking. The exact cause is not fully understood, but it may be linked to genetics, repetitive stress, or certain medications.

Most cases of plantar fibromatosis can be managed with orthotic supports and cushioning.

When to See a Podiatrist

While not all lumps on the foot require medical intervention, certain signs should prompt a visit to a podiatrist. Patients should seek a professional evaluation if they experience:

• Persistent Pain: Lumps causing continuous or worsening pain, especially when walking or wearing shoes, may indicate an underlying issue that requires treatment.
• Changes in Size or Shape: Any lump that grows rapidly, changes in shape, or becomes irregular warrants a closer look to rule out potential complications.
• Skin Discoloration or Temperature Changes: Redness, warmth, or other changes in skin color around the lump could signal infection or inflammation, necessitating prompt care.
• Infection Symptoms: If the lump is accompanied by swelling, tenderness, or drainage, it may be an abscess or other infection that requires antibiotics or drainage.
• Numbness or Tingling: A lump causing numbness, tingling, or a burning sensation might involve nerve compression, which should be evaluated by a specialist to prevent long-term nerve damage.

Podiatrists play a crucial role in diagnosing and managing foot lumps, helping to alleviate symptoms, prevent complications, and maintain overall foot health. Early intervention can often prevent minor issues from becoming more serious, improving outcomes for patients.

Diagnostic Approaches to Foot Lumps

Accurately diagnosing the cause of a foot lump involves a combination of clinical examination and, when necessary, imaging or laboratory tests. Podiatrists typically use the following diagnostic methods:

• Physical Examination: The initial step involves a thorough physical examination. A podiatrist will assess the lump’s size, location, texture, and mobility under the skin. They’ll also check for any signs of tenderness, warmth, or associated symptoms that may indicate inflammation or infection.
• Imaging Tests: To determine the lump’s composition and to rule out underlying bone or soft tissue abnormalities, imaging tests are often required:
  • X-rays can help identify bone-related issues such as bone spurs or fractures.
  • Ultrasound is useful for evaluating soft tissue masses, like cysts or ganglions, and can provide a detailed view of the lump’s internal structure.
  • MRI (Magnetic Resonance Imaging) offers a more comprehensive look at the foot’s soft tissues and is helpful in cases where deeper tissues or complex masses need to be evaluated.
• Biopsy: If a lump appears suspicious or atypical in its appearance or growth pattern, a biopsy may be necessary to rule out malignancy. This procedure involves taking a small tissue sample for laboratory analysis to ensure accurate diagnosis and appropriate treatment.

By utilizing these diagnostic tools, podiatrists can pinpoint the exact nature of a foot lump, enabling targeted and effective treatment options. Early and accurate diagnosis is essential for successful management and minimizing potential complications.

Treatment Options for Foot Lumps

Treatment for foot lumps varies depending on the underlying cause, severity, and symptoms. Podiatrists have a range of options at their disposal, from conservative management to surgical interventions.

A podiatrist will consider the patient’s overall health, lifestyle, and treatment preferences when recommending the most appropriate approach. With the right treatment, most patients can experience relief from symptoms and a return to normal activity levels.

Early intervention and customized treatment plans are key to effective outcomes and long-term foot health.

Non-Surgical Treatments

• Orthotics and Padding: Custom orthotic devices and padding can help relieve pressure on the lump, providing comfort and reducing pain. These are particularly useful for bony growths like bone spurs or soft tissue masses that cause friction in footwear.
• Injections: For inflammatory conditions such as bursitis or plantar fibromatosis, corticosteroid injections can help reduce pain and swelling. This treatment is often combined with rest and modification of physical activities to aid recovery.
• Antibiotics: If the lump is due to a bacterial infection, such as an abscess, antibiotics are essential to clear the infection and prevent it from spreading. In some cases, drainage may also be necessary to remove pus and promote healing.

Surgical Options

• Minimally Invasive Procedures: For conditions like ganglion cysts, podiatrists may perform aspiration, draining the cyst’s fluid to reduce size and alleviate discomfort. This outpatient procedure is generally quick, with minimal recovery time.
• Excision Surgery: For lumps that persist, cause significant pain, or are suspicious in nature, surgical removal may be recommended. This is common for fibromas, large lipomas, and recurrent cysts. Depending on the lump’s location and type, the procedure may be performed under local or general anesthesia.
• Advanced Techniques: In cases where lumps are embedded in complex tissue structures or near important nerves, advanced surgical techniques, including laser surgery, may be used to ensure precision and reduce recovery time.

For Foot Lump Concerns, Contact Salt Lake City Podiatrist Dr. Elizabeth Auger, DPM

If you’re experiencing discomfort from a lump on your foot or ankle, don’t wait for symptoms to worsen. Dr. Elizabeth E. Auger, DPM, is here to help with same-day appointments and is available 24/7 to address your concerns.

As a trusted foot and ankle specialist serving Salt Lake City, Sandy, and West Jordan, Dr. Auger provides compassionate, expert care tailored to your needs. Call (801) 619-2170 today to schedule your consultation and take the first step toward relief.