Question: I am experiencing hot burning feet in bed at night. Is this a medical problem?
Any discomfort or pain in the body is a medical problem, but I assume you are concerned that it may be a symptom of some severe disease.
Hot burning feet can be due to the fact that the feet are actually hot (do they feel hot when you touch them with your hand?), or it could be that your brain perceives that the feet are hot when they are not, because of a problem with the nerves that lead from the feet to the brain. Hot feet may be caused by an excessive blood supply to the feet, so that too much blood is pumped into them, or too little drains out. This may be due to a problem with your circulation, and sometimes is a side effect of medications that treat blood pressure by dilating arteries.
Nerve problems can be due to nerve damage from conditions such as diabetes, or pinching of the nerve somewhere in the leg, pelvis or back. Rarely nerve damage in the spine or brain could lead to inappropriate sensations of heat. You need to see your general practitioner for a thorough check up to see if there is any significant cause for your discomfort.

Question: I have two bunions on each foot on the large toes. They give me pain. Would you advise operation? If so, could I have them done at the same time?
If the big toe is constantly pushed across towards the smaller toes by high-heeled shoes, tight shoes, or a poor way of walking, the big toe may become semipermanently deformed in this direction. The end of the long bone behind the two big toe bones in the front half of the foot (called a metatarsal) is exposed by the deflection of the toe bones, and starts pushing against the skin.
A protective, fluid-filled sac (called a bursa) forms between the bone end and the skin to protect the bone. This sac slowly enlarges to cause a lump that may become tender and painful. This is a bunion. Bunions are becoming less common with more sensible and better-made footwear, and a wealthier society in which correctly fitted shoes can be purchased regularly for a child’s growing feet. Bunions usually start in childhood, but may not cause significant discomfort until adult life.
A number of surgical procedures are available to cure a bunion, but in elderly people, it may be preferable for a protective pad to be worn inside soft or specially made shoes. When bunions are repaired, it is normal for only one side to be done at a time, but in elderly people, in whom immediate mobility is not a concern, both sides can be done at once.

Question: My orthopedic surgeon has diagnosed the lumps under my foot as Ledderhose’s disease, but says there is not much that can be done for it. Can you tell me more about this condition?
A fibrous sheet (the plantar fascia) stretches under the skin of the sole to give it a smooth appearance, strength and firmness, and to protect and control the movement of the muscle tendons that cross under it to the toes. If damaged, the plantar fascia may become scarred, contract and thicken into hard lumps that can be felt under the skin. As the damage progresses, the contraction of the fibrous sheet pulls on the tendons that run underneath it to prevent their free movement. This is Ledderhose’s disease. Men are affected more than women, and a similar condition (Dupuytren’s contracture) occurs in the hand.
The cause is unknown, but may be due to a poor blood supply to the foot (eg. diabetes), and injury to the foot from repeated blows (eg. running). The symptoms include one or more hard, fixed nodules under the skin of the sole that gradually extend lengthwise along the sole to cause discomfort, pain with walking and loss of toe mobility. Eventually the toes cannot be fully extended, and contract into a claw-like appearance. The middle toes are usually more severely affected than the others. Treatment involves soft shoe insoles, injection of steroids around the nodule, and in severe cases only, the nodule may be surgically excised. Unfortunately, recurrence after surgery is common, and the lumps are usually persistent.