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• Highlights
• Introduction
• Causes
• Risk Factors
• Prevention
• Shoes
• Insoles and Orthotics
• Foot Injury Treatment
• Toe Pain
• Forefoot Pain
• Heel Pain
• Arch Pain
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• References

Foot pain

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of foot pain.

Alternative Names

Bunions; Corns; Hammertoe; Plantar fasciitis

Risk Factors

Nearly everyone who wears shoes has foot problems at some point in their lives. Some people are at particular risk for certain types of pain.

Age

The Elderly. Elderly people are at very high risk for foot problems. In one study, 87% of older people reported at least one foot problem. Feet widen and flatten, and the fat padding on the sole of the foot wears down as people age. Older people's skin is also dryer. Foot pain, in fact, can be the first sign of trouble in many illnesses related to aging, such as arthritis, diabetes, and circulatory disease. Foot problems can also impair balance and function in this age group.

Children. Foot pain is fairly common even in children. Heel pain is common in very active children ages 8 - 13, when high-impact exercise can irritate growth centers of the heel.

Gender

Women are at higher risk than men for severe foot pain, probably because of high-heeled shoes.

Older Women . Severe foot pain appears to be a major cause of general disability in older women. In a British study of women ages 50 - 70, 83% reported foot problems. In another study, 14% of older disabled women reported chronic, severe foot pain, which played a major role in requiring assistance in walking and in daily activities.

Pregnant Women. Pregnant women have special foot problems from weight gain, swelling in their feet and ankles, and the release of certain hormones that cause ligaments to relax. These hormones help when bearing the child but can weaken feet.

Occupational Risk Factors

An estimated 120,000 job-related foot injuries occur every year, about a third of them involving the toes. A number of foot problems -- including arthritis of the foot and ankle, toe deformities, pinched nerves between the toes, plantar fasciitis, adult acquired flat foot, and tarsal tunnel syndrome -- have been attributed to repetitive use at work.

For example, in a study of New York police officers who walked an average of 3 miles a day, 20% experienced foot pain at the end of their workday. (Insoles can relieve much of this pain.) No studies, however, have scientifically distinguished between injuries due to work versus those due to regular use. This is an important issue because of its potential impact on disability claims.

Sports and Dancing

People who engage in regular high-impact aerobic exercise are at risk for plantar fasciitis, heel spurs, sesamoiditis, shin splints, Achilles tendon, and stress fractures. In one study of aerobic dance instructors, for example, nearly one-third reported injuries in the feet and ankles. Even young athletes are at risk for stress fracture, particularly if they exercise 6 or 7 days a week. Women are at higher risk for stress fractures than men are.

Medical and Physical Conditions

Excess Weight . Anyone who is overweight puts increased stress on the feet and is at risk for foot or ankle injuries.

Diabetes. People with diabetes are at particular risk for severe foot infections and must take special precautions.

Other Medical Conditions. Many other medical conditions, such as osteoarthritis, rheumatoid arthritis, and gout, predispose people to foot problems, as do inherited abnormalities.

Smokers

A 2000 study reported that smokers are at higher risk for blisters, bruises, sprains, and fractures, most likely because they tend to be less fit than nonsmokers. They also may heal less quickly, which, some evidence suggests, affects some foot surgeries.

• Review Date: 12/4/2006
• Reviewed By: Harvey Simon, MD, Editor-in-Chief, In-Depth Reports; Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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