Aging & Health A to Z

Foot Problems

Causes & Symptoms

As you age, your feet tend to spread and lose the fatty pads that cushion the bottom of your feet. If you are carrying extra weight, the bones and ligaments take an extra beating. Also, any abnormalities that you were born with can become more pronounced or painful as your foot joints lose their flexibility and become more rigid with age. Poorly fitting shoes make foot problems worse and actually cause many of them. The skin of your feet also gets drier with age, so that infections can occur more easily.

Specific causes differ depending upon the particular foot problem, as follows:

Bunions
This deformity of the foot may be an inherited trait but may also result from many years of friction due to ill-fitting footwear. Flat feet, gout, and arthritis also increase your chance of developing a bunion.

Corns and Calluses
Corns are caused by friction from poorly fitted shoes or socks or from toes rubbing against each other. Calluses are similar to corns, but develop on the ball or heel of your foot.  

Hammertoes
Hammertoes are caused by abnormal tension in the muscles and tendons around the toe joints, causing them to buckle or flex. Eventually the joint becomes rigid.

Toenail Problems
Ingrown toenails (usually on the big toe) are caused by inherited abnormalities, incorrect trimming of nails, injury to the toe, infection, or friction from poorly fitted shoes.

Abnormally thick, cracked, and yellowing toenails may be caused by fungal infections, friction from shoes, injuries or conditions such as diabetes or psoriasis. 

Diabetic Foot Problems
You may have reduced sensation in your feet from diabetes, making it hard to realize that your foot is injured. Also, blood flow in your feet is impaired in diabetes, so infections can be harder to fight off.

Arthritic Foot Problems
Osteoarthritis, gout, and rheumatoid arthritis are among the conditions that can cause severe foot pain.

Heel Pain
A condition such as plantar fasciitis may be caused by poor foot mechanics, such as an overly flattened or overly arched foot. In either case, the fascia—a ligament running along the bottom of your foot—may become irritated and painful.

Painful heel spurs are small bone growths that appear when the ligament running along the sole of your foot tugs repeatedly on the heel bone.

Arch Problems
Flat feet and its opposite—an abnormally high arch (claw foot or hollow foot)—are caused by an Achilles tendon (the vertical tendon behind the ankle) that is either too tight or too loose. These conditions are usually inherited, but flat feet may also develop after years of wearing high-heeled shoes. In this case, the condition is known as posterior tibial tendon dysfunction (PTTD). Flat feet are also linked to obesity, diabetes, rheumatoid arthritis, or the use of steroids.

Tarsal Tunnel Syndrome
A nerve called the posterior tibialis nerve may get trapped, causing irritation and painful symptoms.

Achilles Tendonitis
If you are obese, you may develop Achilles tendonitis from years of extra stress on the tendon. It is also associated with an inherited shortened Achilles tendon or from wearing high-heeled shoes. Sudden severe Achilles tendonitis or even a ruptured Achilles tendon may occur as a side effect of certain antibiotics (fluoroquinolones such as Levoquin or Cipro).

Morton’s Neuroma
In this condition, thickened tissue wraps around the nerves that lead to your toes. It is usually due to overly tight shoes, arthritis, injury, or malformed bones. The result is nerve compression.

Risk Factors

You are at higher risk of developing foot problems in later life in the presence of any of the following factors:

• Frequent wearing of poorly fitted, pointy or high-heeled shoes
• Diabetes (especially if you have calluses or corns, poor circulation, loss of sensation, or poor eyesight)
• Neuropathy (loss of sensation) in the feet and ankles
• Other types of nerve or muscle damage (hammertoes)
• Arthritis
• Certain occupations that involve a lot of standing
• Injuries to the feet, toes or ankles
• Abnormal blood vessels
• Flat feet or highly arched feet
• Walking often on hard surfaces
• Overweight.

Symptoms and Warning Signs

Check your feet regularly, and watch out for signs such as dry skin, brittle or thickened nails, burning or tingling sensations, unnatural skin or nail colors, and feelings of cold or numbness. Signs of specific conditions are listed below: 

Bunions
A bunion looks like a bump on the outside of your big toe.  It may be painless, but often causes discomfort because of inflammation and irritation of the supporting tissues under the bone. Bunions may become red, warm, inflamed, and very sensitive to pressure.

Corns and Calluses
To protect delicate inner tissues, your feet grow thickened layers of skin to guard against repetitive pressure or rubbing. Calluses that get too big or hard can damage the tissues underneath and cause painful friction.

Hammertoe
One of the small toes, usually the second toe, becomes permanently flexed, curled and out of line with the other toes. This makes it very difficult to find comfortable shoes.

Toenail problems

Ingrown toenails may become infected and there may be minor pain when the nail is pressed. Fungal infections of the nail can also be painful.  Abnormally thick, cracked, and yellowing toenails may fall off eventually.

Diabetic Foot Problems
If you see red areas or spots, you may have an infection. Be very careful if you develop blisters or calluses or if you have ingrown toenails. In diabetes, a small cut can quickly lead to a severe infection that may put you at risk of a foot ulcer or even loss of your foot. Up to three-quarters of all amputations in diabetic people could be prevented with better monitoring of early danger signs. Severe problems with blood circulation in people with diabetes can also cause foot pain at night.

Arthritis Foot Problems
Joint changes associated with osteoarthritis (the most common type of arthritis), rheumatoid arthritis, or gout can lead to  painful joint malformations, chronic dislocations, swelling, stiffness, and rigid joints. In gout, usually one joint—the big toe—becomes swollen and intensely painful.

Heel Pain
Plantar fasciitis: Pain along the bottom inside edge of your foot will be evident when you stand, especially first thing in the morning. It may come and go, and feel better after resting, but can become a long-term condition if ignored.

Heel spurs: You may not know you have heel spurs, but they often cause pain on the bottom of your foot with walking and are commonly associated with plantar fasciitis.

Arch Problems
Flat feet and feet with abnormally high arches can lead to painful changes in aging feet as the cushioning fat pads disappear.

Tarsal Tunnel Syndrome
Pain along the bottom of the foot causes numbness, tingling, or burning, especially at night.

Achilles Tendonitis
The tendon that runs vertically from your heel causes severe pain that makes walking extremely difficult when it becomes inflamed.

Morton’s Neuroma
The inflamed nerve causes burning or tingling sensations and cramping in the front of the foot.

Updated: March 2012
Posted:  March 2012