A bone spur is a painful bump on the top of the foot which is actually a bony enlargement. This bump is common where the first toe joint meets with the middle of the foot. This bump grows in response from friction or pressure from an imbalance. It often becomes irritated and painful.

In addition, it may create a soft tissue bursae -- sac of fluid -- or Ganglion cyst.

If you are very flat-footed or pronate (roll inward at the ankle) too much, or if you are bow-legged and have excessive heel wear on the outsides of your shoes, this may lead to a bone spur on the top of the foot. It could also possibly lead to a bunion joint on the sides of the foot.

Arthritis often results from the friction and wear-and-tear of the joint. In the early stages, biomechanical foot balancing with an orthotic and a change of lacing design may be helpful. Try to skip over the bump with the lace and cross the lace behind the bump. In more severe cases, a procedure to reduce the bump or the arthritis will give relief.

Most important is that one must always understand the cause-and-effect principle so that there is no reoccurrence of the existing problem.

Dr. Robert Weiss lives in Westport and has a sports-podiatry practice in Darien. He is a former marathon runner and was a member of the Medical Advisory Committee of the 1984 and the 1988 Olympic Trials.