Question: I have severe pain at the back of my heel that flares up whenever I start running. I am young, and trying to keep fit, and this constantly prevents my running.
Running puts a great deal of stress on the attachment of the large Achilles tendon into the back of the heel bone. With the constant jarring and pushing on this point, th§ tendon may tear and separate slightly from the bone, leading to acute pain and tenderness at the site. Treatment is by rest, and anti-inflammatory tablets. Occasionally, an injection is given into the sore point to settle the inflammation, and very rarely surgery is required. If you do not rest for long enough, or start running too hard too soon, the problem rapidly recurs.
Running is not the best form of exercise to keep fit because of the excess stress it places on feet, ankles and knees. Swimming and cycling are far more effective, and it is probably better to keep fit with these for a season until the heel has completely healed rather than run.

Question: What can cause pain in the front half of the foot? I cannot recall injuring it in anyway.
Gout is a severe and obvious cause of foot pain, but there are several other common causes.
Metatarsalgia is a condition common in athletes. It is an inflammation of the bones that form the ball of the foot, and is due to prolonged running, jumping or walking, usually on hard surfaces. Soldiers on route marches may develop the condition. Severe pain may develop in the ball of the foot, and the treatment is primarily rest, and anti-inflammatory medications. A ‘march fracture’ of the fore foot bones, due to the stress of continued walking or running on the foot may be another cause. There are minimal changes on x-ray, but excruciating pain on attempting to walk. Six weeks rest heals these fractures. In the elderly, foot pain may be the first sign of poor circulation, diabetes, rheumatoid arthritis or neuralgia.
Because these conditions can be serious, the cause of the pain must be investigated by a doctor and the correct treatment started.

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.