Foot Problems

Basic Facts

Foot pain and foot disorders are common concerns for older people. Foot pain makes it harder to walk and carry out your daily functions, and can interfere with activities such as getting out of a chair or climbing stairs. You may also have trouble with your balance, which can increase your chances of falling. Pain that leads to less mobility can result in weight gain, weakness, and decreased heart function. But just because you are getting older, you do not have to put up with foot pain. Being able to walk well is extremely important, since walking is one of the best ways to exercise and keep fit. 

Structure of the Foot

Each of your feet contains 26 bones, 33 joints, and more than 120 muscles, ligaments, tendons, and nerves. These all work together to support the weight of your body, act as shock absorbers, keep you balanced, and push you forward with each stride. On average, people spend about four hours standing on their feet every day and take around 5,000 individual steps. Because feet are small compared to your whole body, they receive an enormous impact with each footfall, adding up to hundreds of tons of weight every day.

One of the main causes of foot problems is poor-fitting shoes. Three out of four people over the age of 65 wear shoes that are too small. Narrow or high-heeled shoes, shoes with slippery soles, or shoes that offer no protection or support may cause serious injury and pain and increase your chance of a fall.

Most foot problems can be treated effectively. A podiatrist is a trained healthcare professional who specializes in treating feet. Podiatrists can diagnose your condition and choose the appropriate treatment. Often a change in footwear will do the trick. You do not have to suffer needlessly.

You can keep active and independent by maintaining basic foot care and seeking quick attention from a podiatrist if you have any foot problems. 

What are Foot Problems?

Decades of standing changes your feet. Much of the natural cushion of padding under your heel and the ball of your foot is lost. The arches get flatter and less flexible, your ankles and foot joints become stiffer, and your whole foot gets wider and longer.

Because of these changes, you may develop foot pain and other problems even if you never had difficulties with your feet before.

Certain medical conditions put you at greater risk of foot problems. For example, diabetes can cause reduced blood circulation and nerve damage in the feet. Poor circulation from other reasons such as hardening of the arteries, or peripheral arterial disease, can also cause foot problems.

The Most Common Types of Foot Problems

In older adults, the foot complaints encountered most often are:

  • Bunions.  A bony growth or misaligned bone at the base of the big toe, or sometimes on the small toe. Eventually, the big toe may bend abnormally toward the small toes.
  • Calluses and corns.  Dead, yellowish, thickened skin on toes.
  • Hammertoes.  Toe joints (usually the second toe but all the middle toes may be affected) that curl up or under, either rigidly or with some flexibility, often resulting in a permanently dislocated joint.
  • Toenail problems.  Ingrown (growing into the skin), thickened, or discolored toenails.
  • Foot problems related to diabetes. These can include stubborn foot ulcers that are difficult to heal, loss of feeling, or circulation problems.
  • Foot problems associated with deformities. These may be caused by arthritis (including rheumatoid arthritis and gout).
  • Heel pain.  This pain is present at the back of the arch from heel spurs (bony outgrowth) or plantar fasciitis (an inflamed ligament along the bottom of the foot).

Some other foot problems that are less common but may be encountered among older people include:

  • Arch pain. From fallen arches (flat feet), or abnormally high arches.
  • Tarsal tunnel syndrome. A type of pinched nerve disorder.
  • Achilles tendonitis. Inflammation of the tendon that connects your heel bone to your calf muscle.
  • Morton’s neuroma. A nerve growth between the third and fourth toes.

How Common are Foot Problems?

One in three people over the age of 65 has foot pain, stiffness, or aching feet. Older people who are living in long-term care facilities tend to have even higher rates of foot problems. In the United States, up to 87% of people have painful feet at some time in their lives. Most of these problems are from poorly fitting shoes, such as pointy-toed or high-heeled shoes. Older or obese people, women, and people with diabetes, cardiovascular disease, osteoporosis, or knee, hip, or back pain have much higher rates of foot problems. For women, pain in the toes and ball of the foot is much more common than in men, and it gets worse with age. However, pain in the heel tends to decrease as we get older.

Older people are more likely to have foot pain if they also have a chronic disease. Foot pain in younger people tends to come from aching muscles and stress on bones.  In older people, pain most often comes from corns, calluses, and toe deformities, of which 75% are bunions. As much as one-third of all older people have a bunion. About 30% of older people with foot pain have calluses and about 15% have corns on their toes.

It has been estimated that one-third of all older people have fungal infections in a toenail. The likelihood of having a fungus infection is even higher in older people with diabetes, psoriasis, reduced immunity, poor circulation, or obesity.

 

Last Updated June 2020