Types of Foot and Toe Lumps
By Location
- Toe lumps:
- Big toe (hallux)
- Lesser toes
- Between toes
- Nail bed area
- Forefoot:
- Ball of foot
- Metatarsal heads
- Under toes
- Midfoot:
- Arch area
- Top of foot
- Sides of foot
- Hindfoot:
- Heel
- Achilles area
- Ankle region
By Characteristics
- Soft lumps: Cysts, lipomas, bursae
- Hard lumps: Bone spurs, exostoses
- Mobile lumps: Can move under skin
- Fixed lumps: Attached to deeper structures
- Painful lumps: Often inflammatory
- Painless lumps: May be cysts or tumors
Common Causes
Bony Deformities
- Bunions (Hallux valgus):
- Bony bump at big toe joint
- Toe deviation
- Progressive deformity
- Often hereditary
- Worse with tight shoes
- Can be painful
- Bunionette (Tailor's bunion):
- 5th toe joint bump
- Similar to bunion
- Outside of foot
- Shoe pressure irritation
- Hammertoes/Claw toes:
- Bent toe deformities
- Bumps on top of toes
- Corns and calluses
- Progressive condition
- Bone spurs:
- Extra bone growth
- Often from arthritis
- Can be painful
- Various locations
Soft Tissue Masses
- Ganglion cysts:
- Fluid-filled sacs
- Near joints or tendons
- Soft, round masses
- May change size
- Usually painless
- Can disappear spontaneously
- Plantar fibroma:
- Nodule in arch
- Firm mass
- Slow growing
- Can be painful
- May be multiple
- Lipomas:
- Fatty tumors
- Soft, moveable
- Painless usually
- Slow growing
- Benign
- Mucoid cysts:
- Near toenails
- Clear fluid-filled
- May affect nail growth
- Can be painful
Inflammatory Conditions
- Gout tophi:
- Uric acid deposits
- Firm, chalky lumps
- Often at big toe
- Can ulcerate
- Sign of chronic gout
- Rheumatoid nodules:
- Firm lumps
- Over pressure points
- Associated with RA
- Can be multiple
- Bursitis:
- Inflamed fluid sacs
- Over bony prominences
- Soft swelling
- Often painful
Infections
- Abscess:
- Pus collection
- Red, hot, painful
- May have fever
- Needs drainage
- Cellulitis:
- Skin infection
- Spreading redness
- Swelling
- Requires antibiotics
- Plantar warts:
- Viral growths
- Rough surface
- Black dots visible
- Can be painful
- Contagious
Vascular Causes
- Varicose veins:
- Enlarged veins
- Blue/purple color
- May bulge
- Can be painful
- Hemangiomas:
- Blood vessel tumors
- Red or purple
- Can be raised
- Usually benign
Skin Conditions
- Corns and calluses:
- Thickened skin
- Over pressure areas
- Can be painful
- From friction
- Dermatofibromas:
- Firm skin nodules
- Brown or pink
- Dimple when squeezed
- Benign
- Inclusion cysts:
- Under skin surface
- Contains keratin
- Round, firm
- Can become infected
Rare but Serious Causes
- Soft tissue sarcomas:
- Malignant tumors
- Deep, firm masses
- May grow rapidly
- Painless initially
- Melanoma:
- Skin cancer
- Dark, irregular lesion
- Can occur on foot/toe
- Needs early treatment
- Bone tumors:
- Primary or metastatic
- Hard, fixed masses
- May cause pain
- Bone destruction
Associated Symptoms
Local Symptoms
- Pain or tenderness
- Swelling around lump
- Skin color changes
- Warmth or coolness
- Difficulty wearing shoes
- Altered gait
- Numbness or tingling
- Skin breakdown
Functional Impact
- Walking difficulty
- Balance problems
- Shoe fitting issues
- Activity limitations
- Sports interference
- Work restrictions
Red Flag Symptoms
- Rapid growth
- Color changes (especially dark)
- Ulceration or bleeding
- Severe or increasing pain
- Signs of infection
- Systemic symptoms (fever, weight loss)
- Multiple new lumps
Diagnosis and Evaluation
Medical History
- Duration of lump
- Growth rate
- Pain characteristics
- Trauma history
- Previous foot problems
- Family history
- Systemic diseases
- Occupation and activities
Physical Examination
- Visual inspection
- Palpation of mass
- Size measurement
- Consistency assessment
- Mobility testing
- Skin evaluation
- Vascular assessment
- Neurological testing
Diagnostic Tests
- Imaging:
- X-rays (bone abnormalities)
- Ultrasound (soft tissue)
- MRI (detailed imaging)
- CT scan (bone detail)
- Laboratory tests:
- Blood tests (gout, infection)
- Inflammatory markers
- Uric acid levels
- Biopsy:
- Fine needle aspiration
- Core biopsy
- Excisional biopsy
- For suspicious lesions
Treatment Options
Conservative Management
- Observation:
- For stable, benign lumps
- Regular monitoring
- Photo documentation
- Footwear modifications:
- Wider toe box
- Soft materials
- Custom shoes
- Padding
- Orthotics:
- Pressure redistribution
- Cushioning
- Support
- Custom devices
Medical Treatments
- Medications:
- Anti-inflammatories
- Pain relievers
- Gout medications
- Antibiotics for infection
- Injections:
- Corticosteroids
- Aspiration of cysts
- Sclerosing agents
Surgical Options
- Excision:
- Complete removal
- For tumors, cysts
- Biopsy included
- Bunion surgery:
- Realignment procedures
- Bone cuts (osteotomy)
- Joint fusion
- Toe corrections:
- Hammertoe repair
- Tendon transfers
- Joint resection
Physical Therapy
- Stretching exercises
- Strengthening programs
- Gait training
- Balance exercises
- Manual therapy
- Modalities for pain
Prevention
- Wear properly fitting shoes
- Avoid high heels and narrow toe boxes
- Maintain healthy weight
- Regular foot inspections
- Proper foot hygiene
- Treat foot problems early
- Use protective footwear when needed
- Address gait abnormalities
- Manage underlying conditions
- Regular podiatry check-ups if at risk
When to See a Doctor
See Doctor Promptly
- Any new lump or mass
- Rapidly growing lump
- Painful masses
- Color changes in lump
- Ulceration or bleeding
- Signs of infection
- Limiting daily activities
- Multiple lumps appearing
Regular Monitoring Needed
- Known benign conditions
- Progressive deformities
- Diabetic foot changes
- Post-surgical lumps
- Family history of foot problems