Многие пациенты не придают особого значения, когда у них внезапно возникает болезненное уплотнение на стопе, и принимают его за обычное мозолистое образование. Патологии подобного рода достаточно часто сопровождаются сильным дискомфортом для пациента, а при отсутствии адекватных мероприятий способны вызвать серьезные деформации стопы и привести человека к хромоте. Во избежание серьезных осложнений, необходимо проконсультироваться с лечащим врачом и остановить патологический процесс на начальной стадии его образования.
Классификация уплотнений на стопе
Если на ступне появилось уплотнение, которое причиняет боль, следует классифицировать его для назначения адекватной терапии. Характерная форма уплотнения напоминает шар, размеры которого от 1-2 мм до 3-4 см. При нажатии на уплотнение возникает резкая боль.
Наиболее распространенными факторами, когда на стопе появилось уплотнение и болит, могут являться следующие состояния:
Натоптыши
При ороговении кожи на ступнях, которое спровоцировано неправильно подобранной обувью, ожирением, повышенной потливостью, плоскостопием, артритом и т. д. Эта причина является наиболее частой. Натоптыши могут быть плоскими, сухими, выпуклыми, со стержнями и без них. Они обладают желтовато-коричневым оттенком, шершавой поверхностью кожи с пониженной чувствительностью к внешнему воздействию.
В некоторых случаях возможно растрескивание стопы, сопровождающееся возникновением боли при повышенных физических нагрузках. При отсутствии своевременного лечения возможно деформирование стопы, ее смещение, увеличение подушечки большого пальца.
Мозоль
Отличительной особенностью мозолей является их форма, представляющая собой круглый, ограниченный участок кожи на пятке или пальцах стопы, который даже при небольшом давлении сопровождается болью. Нередко мозоли могут появиться у ребенка, что связано с неправильным выбором обуви, плоскостопием и травмами.
Мозоли бывают мокрыми и сухими. Наиболее опасны мокрые мозоли, так как в них наблюдается скопление жидкости (кровь, серозный экссудат), которые могут вытекать при травматическом повреждении мозоли. В результате этого существует возможность инфицирования раневой поверхности. Помимо этого, мокрые мозоли способны преобразовываться в сухие, но с более глубокими корнями.
Для полного избавления от мозолей потребуется достаточно много времени. При развитии воспалительного процесса может быть назначена антибиотикотерапия, а при тяжелом течении симптоматики рекомендуется оперативное вмешательство.
Бородавки
По внешнему виду бородавки очень похожи на мозоли. Цвет образовавшихся шишек практически не отличается от цвета кожи, а стопа при пальпации шероховатая. При надавливании на подошвенную бородавку наблюдается острая боль. Отличием бородавки от мозолей является присутствие у нее темной точки в середине, но при глубоком прорастании бородавки заметить ее достаточно сложно.
Штаммы вируса, виновные в образовании бородавки на подошве стопы, не опасны. Вирус не способен передаваться от человека к человеку и активизируется только во влажной теплой среде. Для появления бородавки обязательно необходима исходная точка (ссадина, травма и т.д.), а также ослабление иммунной защиты организма.
Важно! После хирургического удаления бородавок требуется длительный реабилитационный период, так как корни бородавки прорастают достаточно глубоко, что требует более радикальной хирургии.
Атерома
Уплотнение подобного вида достаточно подвижно и мягкое на ощупь. Причиной образования атеромы является воспалительный процесс в сальной железе. При физических нагрузках на нижние конечности вероятно возникновение болевой симптоматики, а также деформации различного вида в своде стопы.
Главное условие успешности терапии при атероме – это тщательное соблюдение гигиенических мероприятий, профилактика нарушения целостности кожных покровов, нормализация иммунной защиты и выбор правильной обуви.
Тромбофлебит
Это заболевание сопровождается уплотнениями в области нижних конечностей и характеризуется хроническим течением. В процессе нарушения тока крови образуется сгусток (тромб), больные вены воспаляются, а в месте развития патологического процесса возникает уплотнение темно-синего цвета. Даже при небольшом надавливании на бугорок возникает резкая и сильная боль.
Бурсит
Такое заболевание в большинстве случаев характеризуется доброкачественным опухолевидным образованием, заполненным гелеобразным содержимым. При пальпации уплотнение круглое, подвижное, эластичное и мягкое. Болевая симптоматика возникает в результате физической нагрузки на пораженную ногу. Терапевтические мероприятия при бурсите предусматривают иммобилизацию пораженной конечности, ношение удобной обуви, физиопроцедуры.
При хроническом развитии бурсита выполняется хирургический прокол бурсы с последующим промыванием полости антибиотиками и назначением гормональных препаратов.
Флегмона
Причиной образования уплотнения при флегмоне могут стать даже небольшие ранки или трещины стопы. Нередко флегмона развивается после фурункулов, карбункулов и длительно незаживающих язвенных новообразований. Место воспаления красное и горячее на ощупь, присутствует острая нестерпимая боль, слабость и ухудшение общего состояния пациента.
Флегмоны требуют обязательного лечения, в том числе и хирургического, так как при различных осложнениях возможна ампутация конечности, а в некоторых случаях пациент может погибнуть. Поэтому при первых симптомах заболевания следует незамедлительно обратиться в медицинское учреждение.
Пяточные шпоры
При повышенном отложении кальция возможно образование пяточной шпоры. При этом мягкие ткани стопы сдавливают нервные окончания, причиняя человеку нестерпимую боль. Как правило, частота образования пяточных шпор внутри сустава увеличивается в пожилом возрасте, что обусловлено изнашиванием жировой ткани снизу стопы.
Лечение выполняется наружными лекарственными средствами и внутрисуставными блокадами, которые эффективно снимают воспалительный процесс, купируя болевую симптоматику. При отсутствии положительного результата рекомендуется оперативное вмешательство.
Кератодермия
Это заболевание встречается крайне редко и причины его возникновения до конца не изучены. Предположительно к кератодермии могут привести генетические мутации. В эту группу включено несколько видов дерматозов, сопровождающихся нарушением ороговения. Внешне нарост напоминает желто-коричневый бугорок, слегка возвышающийся над кожей с присутствием на нем небольших углублений.
Уплотнения доставляют пациенту дискомфорт, а в некоторых случаях они могут указывать на развитие серьезного воспалительного процесса в организме. Заболевание рекомендуется лечить, как внутреннее аутоиммунное нарушение. Характерными симптомами кератодермии являются отсутствие боли и постоянный зуд.
Способы лечения
Если появилось уплотнение на стопе и на нее больно наступать, в первую очередь необходимо проконсультироваться с врачом, так как существует достаточно много причин, исходя из которых, подбирается индивидуальное лечение.
Для избавления от натоптышей используются следующие способы:
- криодеструкция (применение жидкого азота) – этот метод борьбы характеризуется отсутствием рубцов и шрамов после удаления нароста на стопе;
- использование лазерного луча – позволяет воздействовать на глубокие ткани;
- наружные средства (кремы, мази и гели) – обладают антисептическим и размягчающим воздействием на пораженные ткани. Наиболее часто используется мазь Бенсалитин и крем Лекарь;
- лейкопластыри и карандаши, обладающие лечебным эффектом – Шуянгсуань, Салипод и другие средства этой группы.
Помимо этого, в аптеках можно купить носки, которые пропитаны специальными лекарственными травами, снимающими патологический процесс. Перед тем, как ими воспользоваться, необходимо внимательно прочитать инструкцию, которая прилагается к упаковке.
Если появляются мозолистые образования, рекомендуется выполнение следующих процедур:
- при мокнущих мозолях поврежденная кожа аккуратно удаляется с соблюдением всех правил стерильности и обрабатывается антисептиком (фурацилином, перекисью водорода, хлоргексидином и т.д.), для предупреждения дальнейшего инфицирования;
- сухая мозоль ежедневно обрабатывается смягчающими кремами, маслами (глицерином, касторовым маслом и т.д.) до полного заживления уплотнения. Мозоли можно лечить самостоятельно, в зависимости от того, на какой стадии деформации они находятся;
- лечение бородавок, которые привели к уплотнению на стопе, требует применения противовирусных средств, например, Ферезола или Подофиллина. Кроме того, активно используются наружные средства с ретиноидами, салициловая кислота и народные способы лечения (сок чистотела, чеснока, лука и т.д.).
При отсутствии эффективности рекомендуется прибегнуть к лазерному удалению бородавки (папилломы) или хирургическому вмешательству.
Профилактика появления уплотнений
Огромное значение в предупреждении появления уплотнений на стопе имеет профилактика, включающая:
- соблюдение гигиенических мероприятий;
- рекомендуется обрабатывать ноги питательными кремами и травяными отварами;
- положительное воздействие оказывает специальный комплекс гимнастики для стоп;
- для того чтобы стопы не болели, рекомендуется проведение массажа;
- врачи рекомендуют заниматься плаванием, легким бегом, ездой на велосипеде и ходьбой босиком по песку и траве;
- любые ссадины, раны и порезы на ступне, и особенно под пальцем, следует своевременно обрабатывать;
- обувь должна быть удобной, а каблук оптимальной высоты.
При соблюдении профилактики вполне возможно предупредить образование более серьезного уплотнения (стержневого) на стопе. В том случае, когда, несмотря на все советы, избежать уплотнения не удалось, необходима профессиональная медицинская помощь для корректировки дальнейших действий.
Самостоятельно пытаться справиться с новообразованием не следует (за исключением сухих мозолей), так как подобное вмешательство способно привести к инфицированию и дальнейшему распространению воспалительного процесса. При внимательном отношении к состоянию собственного организма вполне возможно избежать негативных последствий в дальнейшем.
Легкая походка, красивая осанка, хорошее самочувствие – все это может испортить обычное на первый взгляд шишка на ноге под кожей. Ее появление нередко свидетельствует о начале развития в организме какого-либо заболевания. Проверка этого новообразования, устранение его причины дает шансы на предотвращение болезни и сохранения здоровья.
Шишка на ногах
Шишки на ногах под кожей – нередкое явление. Их появление первоначально не вызывает беспокойства у человека. Только быстрое увеличение шишки в размере, покраснение, сильная боль, неэстетический вид ног заставляют прийти на прием к врачу.
Такие новообразования могут быть разными по величине, происхождению, расположению на ногах, внешнему виду. Бывают множественными и единичными, мягкими и твердыми, вызывающими боль и безболезненными, язвенными и воспаленными, злокачественными и доброкачественными.
Нередко некоторые их виды при запущенном лечении перетекают в серьезные осложнения: воспаление, нагноение, приобретение злокачественной природы.
Часто встречающиеся виды шишек
Заболеваний, которые приводят к образованию подкожной шишки, много. Назовем самые распространенные из них. 
Подагра
Заболевание, развивающееся при нарушении обмена веществ, метаболизма и гормонального фона. При нем соли мочевой кислоты начинают стремительно откладываться в суставах. Появляются боль и отек, покраснение возле пораженного патологией сустава, блеск покрова кожи, поднимается температура, присутствует слабость. При переходе подагры в хроническую стадию под кожей формируются красные шишки (тофусы), которые немного размягчаются при приступах. Они могут появляться в любой части тела, в том числе на руках. 
Бурсит
Это развитие воспаления в синовиальных суставных мешочках. Различаются острая и хроническая формы. Первая – результат полученной травмы в районе околосуставной сумки, а также может являться последствием перенесенных гриппа, фурункулеза, остеомиелита. Поражению подвергаются коленные, локтевые суставы, реже тазобедренные. Под кожей в области пораженного сустава формируется мягкоупругий шарик. Он постоянно болит, поднимается температура. Если не обратиться своевременно к врачу, заболевание будет прогрессировать и перейдет в хроническое состояние.
Оно развивается при запущенной острой форме, регулярном воздействии на околосуставную сумку. Патология не приводит к нарушению двигательной функции, но вызывает некоторые ее ограничения. Пренебрежение лечением приводит к тому, что такой «шарик» болит, под кожей образует долго незаживающее отверстие в виде свища, развивается артрит. 
Варикозное расширение
Варикоз – увеличение объема вен, расположенных близко к поверхности кожи. Болезнь чаще проявляется на ногах, но не исключено ее проявление на стенках пищевода, прямой кишки и мочевого пузыря, влагалища, руках. Патология провоцирует развитие воспаления в венах. Они постепенно отвердевают и образуют аневризмоподобные локальные расширения – красные узлы или шишки.
Основными признаками варикоза являются:
- отекание лодыжек и голени;
- появление венозной подкожной сетки;
- образование язв, мозолей;
- развитие экземы, пигментации на голени и лодыжках;
- отек.
Причинными факторами болезни считаются: возрастная трансформация стенок вен, малоподвижный образ жизни, длительное сидение, беременность, дефекты осанки. 
Вальгусная деформация
Если появилось уплотнение на большом пальце с искривлением этого пальца и среднего – это вальгусная деформация. Она внешне представляет округлый шарик с внутренней части стопы. Шишка твердая, постоянно болит, присутствуют краснота и отек. Первопричиной появления являются слабые сухожилия, эндокринные нарушения, остеопороз, артроз, плоскостопие, неудобная обувь. 
Подкожная киста
Это доброкачественное полостное новообразование, заполненное гноем или жидкостью. Может образовываться не только на ногах, но и на руках. Шишка ощущается как средней плотности небольшой шарик. Формируется вследствие инфекции, закрытия сальных желез, попадании инородного тела. Обладает следующими симптомами: не болит, увеличивается медленно, при нажимании сдвигается немного в сторону. 
Дерматофиброма
Безвредные красные, круглые новообразования, образующиеся подкожно на ногах и руках. Точные причины ее появления неизвестны. Их основными признаками являются:
- пурпурные, коричневые или красные наросты;
- их диаметр колеблется в приделах 0,3-0,6 см.;
- в редких случаях вызывают зуд, жжение и боль.
Липомы
Это новообразования представляют собой красные шарики, образовавшиеся из мягкой подкожной ткани. На ощупь липомы – упругие и мягкие шишки. Они растут медленно и не несут вреда здоровью. Появляются как одиночные, так и групповые шишки. Размер большинства находится в приделе 5 см, они не причиняют дискомфорта и неприятных ощущений. Боль возникает только в случае надавливания липом на нервные окончания. 
Увеличенные лимфоузлы
Небольшого размера шарик (до 0,5 см), располагающийся на тыльной стороне стопы или подошве. При ощупывании лимфоузлы плотные и горячие. Образование такого «бугорка» сочетается с инфекционными симптомами: общей слабостью, температурой.
Если появились на ноге подкожные уплотнения, необходимо незамедлительно обратиться к врачу. Своевременная постановка диагноза является залогом успешного лечения и недопущением развития осложнений.
Как проходит лечение?
Помогут справиться с патологией терапевт, ревматолог, дерматолог, онколог, инфекционист. После изучения всех полученных анализов ставится точный диагноз и определяется причинный фактор.
Каждый вид шишки имеет свой метод лечения.
- Если появление шишки является следствием перехода подагры в хроническую стадию, то лечение заключается в предупреждении приступов, снятии боли и отека. Применяются препараты, снижающие уровень мочевой кислоты, противоотечные, обезболивающие, противовоспалительные средства. Дополнительно пациенту рекомендуется соблюдение специальной диеты и курс физиотерапии.
- При формировании шишки в результате прогрессирования бурсита проводится промывание синовиального мешочка, инъекции антибактериальными и противовоспалительными средствами. Проводится физиолечение, назначаются компрессы и контрастные примочки. От пациента требуется соблюдение гигиенических требований, ограничение двигательной активности. Запущенная стадия бурсита не поддается медикаментозному лечению. Больному проводится хирургическая операция.
- Если уплотнение на ноге под кожей образовалось из-за прогрессирования варикоза, лечение проводится безоперационными методами: склеротерапией, лазером, медикаментозно. Лечение поврежденных вен хирургическим иссечением проводится при тяжелой форме болезни.
- При появлении шишки при вальгусной деформации медиками рекомендуется регулярное ношение специальной обуви и стелек. Назначаются противовоспалительные нестероидные и кортикостероидные (редко) препараты. Но чтобы полностью устранить «шарик», потребуется хирургическая операция.
- Если подкожный «шарик» является кистой, то лечение назначается в крайних случаях. Обычно она со временем рассасывается самостоятельно. Если киста воспалена и ее рост прогрессирует, проводится терапевтический курс с последующим хирургическим удалением.
- Дерматофибромная шишка не требует удаления, но при желании пациента можно устранить ее хирургическим путем. Чтобы уменьшить ее размер, сделать плоской, применяется криотерапия – замораживание жидким азотом.
- Липомный шарик хирургического лечения не требует, поскольку соседние ткани не повреждаются. Его удаление выполняется только по желанию пациента или в случае, когда он является видимым косметическим дефектом.
- Формирование уплотнения вследствие воспаления лимфоузлов лечится противовоспалительными препаратами. Во избежание дальнейшего развития воспаления применять прогревание и согревающие компрессы нельзя!
Любую из шишек, появившихся на ноге, нельзя игнорировать. Даже если она не беспокоит, обратиться к врачу все же необходимо.
К своему здоровью следует относится внимательно. Появление любого вида уплотнения является весомым аргументом в пользу посещения специалиста.
Ноги постоянно подвергаются колоссальным нагрузкам. Они вынуждены выдерживать вес всего тела, а если, к примеру, женщина ходит на каблуках, вся тяжесть падает на небольшую часть ступни. Поэтому нет ничего удивительного в том, что иногда появляются шишки на стопе. При таком явлении в большинстве случаев без медицинской помощи не обойтись.
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Даже маленькая бородавка на ступне может ощущаться, как уплотнение, поэтому самостоятельная постановка диагноза не представляется возможной. Но, следующие патологии иметь в виду стоит:
- Мозоль. А именно сухая ее разновидность. Она возникает после заживления жидкой мозоли или при регулярном давлении с трением. Выглядит нарост как бугорок из омертвевшей кожи желтого или серого цвета. Находится шишка на стопе возле пятки или ближе к пальцам. Она безболезненная, лишь иногда возникает чувство жжения. Такие мозоли больших размеров называют натоптышами. Чтобы избавиться от дефекта, следует носить удобную обувь и регулярно отшелушивать омертвевший эпидермис. В тяжелых случаях, когда наросты доставляют существенный дискомфорт, трескаются и кровоточат, показано хирургическое вмешательство в виде иссечения или криодеструкции.
- Гематома. Подкожное скопление крови. Возникает под воздействием травм и ушибов. Проще говоря, это опухший синяк. При его появлении стоит убедиться, что нет перелома. Если вокруг шишки нет опухоли, боль возникает только при нажатии, а ступня легко шевелится, от гематомы избавиться несложно. Достаточно несколько раз в день наносить на нее гепариновую мазь. В противном случае сначала стоит убедиться, что нет перелома.
- Вальгус. Деформация плюсневых костей, при которой большой палец растет в сторону. Его кончик направлен к другим пальцам, а сустав торчит наружу. Из-за этого образуется шишка на стопе сбоку. У больных с таким дефектом наблюдается плоскостопие, а ноги расположены не прямо, а в форме буквы «Х». Пациенты с диагнозом «вальгусная деформация» терпят невыносимую боль и не могут нормально ходить. Им показано ношение ортопедической обуви, массаж и лечебная физкультура. Стойкий эффект компенсации дает операция, но со временем проблема возвращается.
- Болезнь Келлера. Заболевание костей стопы, заключающееся в разрушении губчатой ткани. Затрагивает только детей и подростков. Выделяют два типа патологии. От болезни Келлера No1 страдают мальчики дошкольного возраста. На внутренней стороне тыльной поверхности стопы появляется припухлость, которая болит и мешает нормально ходить. Все симптомы пропадают в течение года.Вторая разновидность присуща девочкам-подросткам. У них заболевание поражает обе ступни и длится около двух лет. На подошве появляется отек, что существенно затрудняет ходьбу. Палец, расположенный рядом с пораженной костью, становится короче.Лечение в обоих случаях включает фиксацию стопы гипсом, ношение ортопедической обуви, лечебную физкультуру и физиотерапию.
- Флебит. Воспаление стенки сосуда. Чаще всего является следствием варикозного расширения вен или заражения стрептококком. Нередко поражает женщин после родов. Обычно выглядит как шишка на стопе сверху. Поверхность над пораженным сосудом опухает и краснеет. По ходу воспаленных вен идут красные полосы. Повышается температура тела, отмечается общая слабость. Нередко пострадавший сосуд закупоривается тромбом. Если поражение поверхностное, показано амбулаторное лечение. В случае расположения очага в более глубоких слоях больного госпитализируют. Ему показана физиотерапия, прием противовоспалительных и средств, улучшающих тонус сосудов и вязкость крови.
- Гигрома. Подкожное опухолевидное образование из серозной жидкости с примесью слизи или фибрина. Его возникновение обусловлено генетически. Также гигромы часто образуются при повторном травмировании одного и того же места. Наибольшая предрасположенность к такому дефекту наблюдается у женщин 20-30 лет. Клиническая картина включает в себя опухоль с четкими границами в районе сустава. Она неподвижна, но кожа над ней легко смещается. При нажатии новообразование болезненно. Если оно сдавливает близлежащие нервы, болезненность присутствует постоянно. На ощупь шишка может быть мягкой, упругой или твердой. Гигрома не представляет опасности для здоровья и не перерождается в рак. Эффективных способов лечения не существует. Возможно только хирургическое удаление. Оно показано, если опухоль доставляет сильный дискомфорт, или в эстетических целях.
- Заболевания костей и суставов. Такие патологии, как бурсит, артроз, артрит, остеомиелит и др. вызывают деформацию кости. Из-за этого на плюсне появляются узловатые утолщения. Лечением таких заболеваний занимается ортопед. Он назначает лечение в зависимости от диагноза.
В первую очередь при появлении необычного нароста в области стопы следует обращаться к хирургу. При необходимости врач направляет к узким специалистам. Лечение шишек в области стоп обязательно. Даже если опасности нет, они доставляют дискомфорт, мешают нормально ходить и затрудняют ношение обуви.
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