Take These Steps to Manage Foot Pain
Here are some non-surgical ways you can address foot discomfort
Mobility can be an issue as you get older, but the problem may begin with foot pain or soreness which makes it harder to walk, stand up or climb stairs. It can affect balance, and could involve other parts of the body such as the knees and spine.
"Ignoring foot pain is often to the detriment of the patient's life," says Dr. Lance M. Silverman, of Silverman Ankle and Foot in Edina, Minn. "Living with it is always an option and patient choice. But there are so many non-surgical management and surgical treatment options available to patients to help them live more productive and fulfilling lives."
Common Causes of Foot Pain
Foot pain or cramping could arise from simple problems with easy solutions or it could signal more serious medical issues:
- Improperly fitted shoes. Many people over 65 wear shoes that are too small. As you age, hormonal changes cause you to lose some of the fat on the bottom of your feet. The ligaments and tendons lose elasticity and spread the feet out. Your size 6 feet from your 20s may now be size 7. Too-narrow toe boxes, high heels or shoes that offer no support to the sides of the foot may also cause pain. Corns, calluses and hammertoes can develop from wearing poorly fitting shoes.
- Muscle cramping. Foot cramps or soreness can sometimes be improved with hydration and good nutrition, as well as with time, says Silverman. However some unusual electrolyte abnormalities can cause cramping and should be evaluated by your primary care doctor. Cramping can also be caused by low levels of potassium, calcium or magnesium. It can be a side effect of certain medications, too. If you experience constant muscle cramping, consult your doctor.
- Peripheral arterial disease or PAD. This describes a problem in which narrowed arteries inhibit blood flow to the extremities. PAD can present with leg or foot cramping pain from activity. “A simple Doppler ultrasound test called an ABI can help identify this problem and help people live more active happier lives. Getting seen to improve arterial flow is essential,” advises Silverman. “But most patients with PAD also have cardiovascular disease and should have their heart arteries checked, as well. Seeing the foot doctor can lead to referrals to cardiology and life-prolonging and enhancing medical care.”
"People who experience foot pain that stops them from their activity goals or makes them change plans should seek care."
- Osteoarthritis. Osteoarthritis is often linked to genetics or being overweight, but can also stem from a past foot or ankle injury. It damages the cartilage joint surface and can cause pain or swelling in the foot or ankle but can also harm the bones and ligaments of the affected areas. Although not a cure, light therapy can offer some relief by stimulating cells and increasing circulation. “Light therapy has some investigated medical benefits, typically from pain relief of arthritis or tendinitis,” says Silverman.
- Rheumatoid arthritis or RA. It's caused when the body’s immune system attacks the membrane that protects the joints. Although osteoarthritis usually starts in one joint, rheumatoid arthritis can affect more than one joint at one time. “RA presents more commonly with foot or ankle complaints than any other joint,” Silverman says.”Swelling and stiffness in the a.m. lasting more than twenty minutes are classic signs.”
- Diabetes. This can cause nerve damage and reduced blood flow to the feet, putting you at risk for foot ulcers. When left untreated, foot ulcers may not heal and may become infected (which, in some cases, could mean surgery to prevent it from spreading). Diabetes may present with foot swelling without a known cause or could be a fracture or a joint dislocation that has gone unnoticed due to the person’s inability to feel. When in doubt, consult a physician.
What You Can Do About Foot Pain
Daily checks of the entire foot — including the bottoms of feet, toes and ankles — should be done in the case of patients with neuropathy, which can cause weakness or numbness. For those with good sensation in the feet, a monthly foot check should be enough.
For best foot health:
- Wash your feet with a mild cleanser and warm water every day to remove debris or bits of flaky skin.
- Check for corns, calluses or blisters that may indicate poorly fitting shoes.
- Cuts, scrapes, blisters or other wounds should be treated and monitored. If you or the person in your care are diabetic and have one of these problems, contact a doctor immediately.
- Be aware of stiffness or swelling, especially around the joints.
- Look for melanoma and other skin conditions that can be “silent” problems.
- After washing your feet, dry them carefully with a soft, absorbent towel.
- Put on clean, soft, socks made from natural fibers. Change your socks once daily or more often to reduce the possibility of bacteria hiding out in the fibers of the socks.
- Make sure you wear the proper size shoe, with an ample toe box and a comfortable heel.
"People who experience foot pain that stops them from their activity goals or makes them change plans should seek care. If anyone has pain that persists, they should be evaluated," Silverman advises. "But annual foot and ankle doctor checkups are only required by patients with neuropathy because they often don't feel the 'soreness' until it's too late." You can also insist that every annual doctor's visit includes the removal of shoes and socks and an examination of the entire lower extremity.
Go Barefoot or Not?
Although it is best to wear shoes to protect ourselves from environmental factors, Silverman suggests going barefoot at home if possible, after ensuring it is a safe, clean place for you to walk.
"People get stronger by being barefoot," says Silverman. "If sensation is intact (no neuropathy due to diabetes or other conditions such as post-chemotherapy neuropathy), then any protection will weaken the foot muscles and doesn't actually provide stability. When people wear shoes they can't use their foot muscles to balance, they can't sense slight shift in weight as quickly. Someone walking around the house without shoes will catch themselves losing their balance earlier as they get more feedback from the floor."
However, Silverman warns, the rules change for older adults with certain medical problems that affect the feet. "Diabetic patients can't protect themselves from injury on even-controlled surfaces, he said. "They do better with shoes that have diabetic, custom total-contact inserts. They should wear those shoes or slippers inside."