Foot Pain

Foot Pain

When you really think about it, it’s amazing that our feet last as long as they do. The 26 bones, 33 joints, 107 ligaments, and 19 muscles and tendons in your feet take 8,000 to 10,000 steps a day, covering more than four times the circumference of the globe in a lifetime. An average day of walking puts several hundred tons of pressure on your feet, which is partly why your feet are easier to injure than any other part of your body.

And when your feet have a problem, they’ll let you know it. First, they send you signals like calluses, black toenails, and bunions. If you only deal with the signals or the symptoms but don’t solve the underlying problem, your feet will eventually send you another message that’s impossible to overlook—pain.

Usually, the problem in question is that your shoes don’t fit right or that you were born with certain foot problems that need to be corrected by a doctor, says Neil Scheffler, D.P.M., podiatrist and president of health care and education for the Mid-Atlantic Region of the American Association of Diabetes in Baltimore. Other factors, however, also come into play. For instance, putting on extra weight as you age can add a tremendous amount of pressure to your feet. Here are some other age-related causes of foot pain.

Plantar fasciitis. The most common cause of heel pain, plantar fasciitis (pronounced fas-ee-eye-tis) becomes more prevalent as you get older. That’s probably because your plantar fascia (a strong, elastic band of fibrous tissue that runs from your heel to your forefoot) gets less flexible over time. As the fascia inflames under the constant strain of walking or standing, it pulls at your heel, sometimes creating a bony prominence called a spur. Though the spur sounds painful, it’s really the tight pull against your heel that causes the pain, says Tzvi Bar-David, D.P.M., podiatrist with Columbia-Presbyterian Medical Center in New York City.

“Think of the plantar fascia as a bowed string that creates the arch of your foot. When you step on this bow, you flatten it and tighten it,” says Dr. Bar-David.

The telltale sign that you have plantar fasciitis is that you feel pain on the inner part of your heel. This usually occurs when you first get out of bed or stand up after sitting for some time.

Fat-pad loss. When you were born, you had nice cushy fat pads under your heels and your forefoot. But as you walked and walked over the years, these pads eventually got flattened out and slowly shrunk away. This is a natural process but can be a painful one since now you have little there to cushion your feet and absorb shock. You’ll feel pain from fat-pad loss under your heel and the ball of your foot.

Arthritis. Use any joint often and rigorously enough, and eventually, you’ll wear away the cartilage that cushions it. In most cases, an injury fails to heal correctly. Then inflammation causes your protective cartilage to rub away, and walking becomes painful. The feet tend to suffer mightily from arthritis because there are so many joints to damage. arthritis manifests itself with pain, swelling, and lumps, most often in the top of your midfoot or in your toes.

Regardless of why your feet hurt, here are some strategies to nip pain in the bud.

Try This First

Stomp on pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can relieve the pain and swelling of most types of foot pain. Follow package directions. This is a temporary fix, however. You don’t want to stay on over-the-counter painkillers for more than a few weeks, advises Dr. Bar-David. So make sure to try other strategies to relieve your specific foot problem.

Other Wise Ways

Bend some toes to stretch a tendon. Much of the pain from plantar fasciitis stems from a tight Achilles tendon (the band that runs down through your heel and connects with your plantar fascia). When it’s tight, your plantar fascia gets less flexible. “Often, if you stretch the Achilles tendon, you’ll end up relieving the plantar fasciitis,” says Dr. Bar-David.

To stretch your Achilles tendon, get in a relaxed position—sitting or lying down—and bend your leg until your toes are within reach. Using both hands, pull your toes toward your shin and hold for 20 seconds.

Or lean in for tendon relief. Another Achilles tendon stretch can be done standing up in front of a wall. Place your hands against the wall and lean forward with your feet firmly planted flat on the ground behind you. Keep your back and feet flat and your knees locked. You will feel your calf stretching if you do this properly, notes Dr. Bar-David. Repeat this 10 times, holding each stretch for 30 seconds.

Vary your stretch times. The Achilles tendon stretches can help alleviate heel pain when it strikes, but you should also do them routinely. Be sure to stretch before and after exercising. Also, stretch before going to sleep and before getting out of bed in the morning. Though you might think your legs and feet are relaxed at night, most people sleep with their feet pointed, keeping the plantar fascia and the Achilles tight all night long, Dr. Bar-David says. So plantar fasciitis is often worst during the first few steps in the morning. By stretching before you rise, you can get your feet off to a good start.

Cushion that heel. Shop around for heel cups, or ask a podiatrist about some cushioning that will make your heel feel better. With extra cushioning, your heels aren’t jarred so much by everyday walking or running. And with the slight heel lift, your Achilles tendon has a chance to relax, which eases the pull on your plantar fascia, explains Dr. Bar-David.

Switch to running or walking shoes. If your foot’s natural padding has eroded over time, wear sneakers. They have extra cushioning in the heel, which helps make up for your somewhat reduced, natural fat pads, says James Michelson, M.D., associate professor of orthopedic surgery at Johns Hopkins School of Medicine in Baltimore. Lace-up shoes also will put less stress on the front of your foot if you have pain there.

Lose weight. If you’ve gained weight over the years, common sense tells you the extra pounds are putting extra pressure on your feet. This can create heel or forefoot pain, warns Dr. Bar-David. The lighter your body, the less your foot pain.

Get cushioned inserts. You can buy inserts to put in the sole of your shoe to absorb more shock. “Usually, it’s all that’s needed,” adds Dr. Michelson.

Go for depth. If inserts and running shoes don’t do the trick, go to a specialty orthopedic shoe store and ask for shoes that provide extra depth. These will allow you to stick even more cushioned inserts into your shoe to absorb even more shock, according to Dr. Michelson.

Avoid high heels. If you’re a woman, wearing high heels could contribute to arthritis and other foot pain. High heels also push all of the force of walking into the front of your foot, where things are tight and immovable. Switch to flats, says Dr. Michelson.

Get your feet measured. Shoes that are too tight will make your feet hurt even more. Most women wear their shoes two sizes too small, notes Dr. Michelson, and many haven’t had their feet measured in at least five years. Since your feet grow as you age, the shoe that fit when you were 40 may be too small now. Have a clerk or a friend measure your feet for you while you are standing. And do this every time you buy a new pair of shoes, advises Dr. Michelson. Some other ways to make sure you get the right fit:

• Shop at the end of the day. Your feet swell over the course of the day and you’ll want shoes that fit when your feet are at their largest.

• Keep in mind that one foot might be larger than the other. When you’re shoe shopping, always fit shoes to your largest foot. (Use cushioning, if necessary, to fill in the gaps in the shoe for your smaller foot.)

• Make sure there’s at least a half-inch between your longest toe and the end of the shoe.

Make ginger a habit. Fresh ginger is a great remedy for arthritis and other pain related to swelling, because it’s a natural anti-inflammatory, says Neal Barnard, M.D., author of Foods That Fight Pain and president of the Physicians Committee for Responsible Medicine in Washington, D.C. Though you don’t have to use a lot of it to get significant relief, you do have to take it regularly, he says.

Buy fresh ginger at the supermarket. Mince up one-half teaspoon to a teaspoon per day. Either put it in your food as a flavoring or mix it into some water and swallow it like a pill. Cloves, garlic, and turmeric, though less studied, have shown similar effects in some people, according to Dr. Barnard.

Rub hot peppers on them. Over-the-counter creams made from capsaicin, the active ingredient in hot peppers, can relieve arthritis and other foot pain, says Dr. Barnard. The lotion may at first cause a burning sensation, which goes away the more you use the stuff. Rub just enough to lightly cover the affected area on your feet whenever you feel pain. Wash your hands thoroughly after each application and keep the cream away from your eyes and other mucous membranes. It can really burn.

Modify your exercise. If your feet hurt because you give them a regular pounding every time you take a brisk walk, change your routine, says Donna Astion, M.D., associate chief of foot and ankle service for the Hospital for Joint Diseases, Orthopaedic Institute in New York City. For instance, try taking every other day off, alternating between weight-bearing activities such as running and nonweight-bearing activities such as cycling. If you run, alternate between hard tar roads and softer surfaces like trails.

Soak them. Treat your feet to a soak in Epsom salts and warm water. The soak can drain swollen tissues and help relieve pressure. Follow the directions on the package, which usually recommend one tablespoon of Epsom salts dissolved in each quart of water.