Improper foot function or biomechanics is the main source for most of the foot pains. Shoes rarely cause foot deformities, but may irritate them. Flat feet or high arches can contribute to painful problems in the feet, knees, and even hips. When the arch is too high or low, other structures in the foot and leg have to work longer and harder than intended.
The added stress, weight, and poor motion can cause fatigue, pain, and inflammation. Arch supports (orthotics) and exercises to stretch and strengthen the arch and lower leg help relieve many problems related to weak arches. But for many people, having flat feet or high arches never causes a problem.
Two closely related conditions : heel spurs and plantar fasciitis
- are common sources of pain in the heel and arch of the foot. They involve the heel bone and the plantar fascia, a strong band of connectivity tissue at the bottom of the foot that runs from the heel to the base of the toes. Its job is to help maintain or hold the arch together and serve as a shock absorber during activity.
Overstretching of this band of tissue can result in strain and later inflammation where it is attached to the heel bone.
Plantar fasciitis is marked by a dull ache in the arch or pain in the heel. The pain is worst when you wake or after resting. Walking may hurt at first, but once the plantar fascia is “warmed up,” the pain may decrease.
Plantar fasciitis most often occurs when activity suddenly increase, or is due to shoes with Poor support. Switching from high heels or boots to flat shoes or athletic shoes irritate the fascia, causing pain. Gaining 10 to 20 pounds can have the effect. Working out or standing and walking on hard surfaces, or wearing shoes that do not good arch support can also lead to problem.
Heel pain and plantar fasciitis often have similar symptoms and are sometimes considered together as heel Spur syndrome. In some cases, spurs may cause a deep tenderness in bottom of the heel when weight is placed on the foot. Self-care and rest will sometimes relieve heel spurs and plantar fasciitis. If symptoms continue despite these measures or if pain is severe, consult the doctor immediately.
It is not the connective tissues in the foot that give way or get inflamed, but the bones themselves sometimes. Stress fractures occur most often in the second metatarsal. The metatarsals are the long bones that connect to the toes.
High-imPact activities such as running, basketball, or high-impact aerobics pose particular risk for stress fractures of the foot. Postmenopausal women with lower bone density, women with absent or infrequent periods, or anyone on longterm steroid or hormone therapy may be more likely to have stress fractures.
In Stress fractures, at first, pain may be mild enough that it can be ignored. After time, however, the mild pain gives way to sudden, intense pain.
Treating stress fractures in the foot mostly involves time, usually at least 1 month to allow the bone to heal. With the exception of fractures in the fifth metatarsal, a cast is usually not needed. A wooden shoe or postoperative shoe is usually worn to allow the fracture to heal. A stress fracture in the fifth metatarsal can be serious because it often resists healing. Fractures may need a cast, and crutches may have to be used for 6 weeks to several months. In some cases, surgery may be needed.
These yellowish calluslike growths develop on tops of the toes in spots where shoes rub, If the rubbing continues, corns can become red, inflamed, and painful. The best way to prevent corns is to wear shoes with a toe box, the area surrounding the toes and ball of the foot, large enough to comfortably fit your foot without rubbing.
A bunion is a swelling on the side of the foot that is usually a symptom that the foot is not working properly, because of a flat-foot condition. Instability and muscle imbalance cause the big toe to slant in toward the other toes. The joint where the big toe connects to the foot (the end of the first metatarsal) pokes out on the inner side of the foot. This is caused by poor alignment and is not a growth of bone. The bunion may also become inflamed and sore, especially if rubbed by a shoe.
Hammertoe is a deformity in which toe buckles, causing the middle joint of the affected toe to poke above the other toes. The deformity may also cause the toe to become bent at the middle joint, so that it turns in toward the toe. Tight shoes can rub and put press the raised portion of the hammertoe often making a corn form. Hammertoe may cause no problems at all.
Plantar warts, like warts in other areas the body, are caused by a virus. Weight bearing causes plantar warts to grow inward. The result is a painful lump on the bottom of the foot that feels like you are walking on a pebble. Children and teens are more likely than adults to get plantar warts. Plantar warts are often difficult to treat, but a slow approach is best. If plantar warts interfere with walking, consult the doctor.
Good shoes can be important in preventing and relieving foot pain. Shoes should support the arch and cushion the heel, ball, and outside of the foot. They shouldn’t pinch the foot or toes or be so loose that your feet slide around in them. A good heel height is generally between 1/2 and 11/2 inches. For shoes that don’t already offer enough arch support or cushioning, commercial arch-support and cushion inserts may be worth buying.
With the exception of plantar warts or trauma to the foot, checking the shoes you’ve been wearing is the first step in caring for foot pain. Antiinflammat0tY drugs (aspirin, ibuprofen, or naproxen) will help relieve pain and inflammation. Other treatments for specific conditions are discussed below.
For heel spurs and plantar fasciitis
Rest the foot, avoiding high-impact activities for 3 to 6 weeks. Switch to low-impact activities, such as walking, biking, or swimming. Walking is particularly good.
Apply ice to the heel two to three times daily.
Support the arches of your feet to protect them from further stretching and tearing. Place arch Supports even in your slippers and put them on first thing when getting out of bed.
For stress fractures
Call the advice nurse if pain continues or Worsens after a week or two of nonimpact activity arid anti.inflammatory drugs.
Avoid high impact activities. Switch to weight-bearing, low-impact or nonimpact activities, such as walking or low-impact aerobics. Weight bearing strengthens bones and prevents bone lo Resume your relar workout or other activities slowly after pain gets better and the future heals.
Soak feet in a solution of Epsom salts and water for 15 minutes. Dry carefully and apply a moisturizer. Rub the corn with a clean nail file or pumice stone, using a side-to- side motion, Repeat daily until the corn is gone.
Use a nonmedicated corn pad to relieve pressure on the area.
Wear shoes with a toe box large enough to accommodate the hammertoe.
Treat accompanying corns as described above.
Choose shoes with a larger toe box (squared or rounded toe).
Put a piece of foam or cotton between the affected toes to see if it eases the pressure.
Place padding around the bunion to relieve pressure and rubbing from shoes. Moleskin and bunion pads are available at most drugstores.
Try using an arch support to stop the jamming of the long bone and the big toe.
Call the advice nurse if pain lasts, interferes with walking, or is not relieved with self-care.
For plantar warts
Soak foot for 10 minutes in a solution of 2 tablespoons mild household detergent (such as dish soap) and 1/2 gallon warm water. Cut a piece of 40 percent salicylic-acid plaster (available at drugstores) the size of the wart and apply it to the wart. Cover with tape or a bandage. Remove the plaster in 2 days. Brush the wart with a toothbrush soaked in soap and water. Repeat this procedure for 2 weeks until the wart is gone.
If warts remain despite self-care, or if they interfere with walking, call the advice nurse.
Do not try to cut warts out.
Signs and Symptoms that needs care
Unable to move foot or bear weight after a trauma, such as a blow or fall.
Pain in heel or arch, especially upon awakening; tender points on bottom of foot between heel and ball.
Corns, plantar warts, bunions, or hammertoes.
Pain, burning, tingling, or numbness in the toes, between the toes, and at the ball of the foot; swelling at the top of the foot; symptoms get worse with pressure.
Heel spurs or plantar fasciitis not relieved with self- care within 3 to 6 weeks.
Suspected stress fracture.
Foot pain from overuse or injury; can bear weight.