If you walk the average amount of 5,000 steps a day, you will clock up over 80,000 miles during your lifetime – the equivalent of walking three and a quarter times round the equator. While this may sound a lot, you should ideally walk twice as far – optimum health benefits are supposedly obtained from walking 10,000 steps a day. But what effect does all this strolling have on your feet? Each foot contains 26 bones, 33 joints and over 100 muscles, tendons and ligaments, so there’s a lot that can go wrong. It’s not surprising that as many as 80% of adults experience foot pain on a regular basis.
- Beware high heels
- Common causes of foot pain
- Athletes’ foot
- Claw toe
- Club foot
- Diabetic foot problems
- Drop foot
- Flat feet
- Hammer toe
- Heel spur
- Ingrown toenail
- Morton’s neuroma
- Pigeon toes
- Plantar warts
- Policeman’s foot (plantar fasciitis)
- Pronation problems
- Rheumatoid arthritis
- Shin splints
- Tarsal tunnel syndrome
- Tired achy feet
- Dealing with painful feet
Beware high heels
Many foot problems are caused by wearing ill-fitting shoes or high-fashion footwear that bears little relation to the shape or function of the feet. Women are four times more likely to develop foot problems such as corns and bunions than men, and some of this risk comes down to wearing high heels (although men are equally prone if they wear high heels, too).
When you walk, the downward force on each foot, with every step, is enormous. The heel of a person weighing one hundred pounds can exert pressures of up to two thousand pounds per square inch during walking. No wonder wooden floors are readily damaged by stiletto shoes!
High heels do not properly support your feet and can cause tendons to weaken, especially if you spend long periods of time standing. High heels increase pressure on the ball of your foot, and the tiny, sesamoid, pea-sized bones under your big toe. As well as causing foot pain, repeatedly wearing high heels increases the risk of developing flat feet, hammer toe, back problems, bunions and corns. Backless high heeled shoes are the worst for your feet, as they force your toes to claw while you walk.
In addition, high heels alter your posture and increase strain on your back, hips and knees, to increase your risk of future osteoarthritis.
If you want to avoid foot problems, it’s advisable to wear heels that are less than 6cm high (2.4 inches) whatever gender you identify with. If you are on your feet all day reduce this to a 2cm heel.
When you wear high heels for a function, carry a pair of flats with you to wear to and from the event. Your feet will definitely thank you in the long-term!
Having worked as an orthopedic surgeon and helped to surgically remove a shed load of bunions, and operated on claw toes and hammer toes, believe me – I never wear high heels!
Common causes of foot pain
If you have persistent pain in your feet, do seek medical advice. New orthopedic scanning machines (CurveBeam’s pedCAT) are set to transform the diagnosis and treatment of foot and ankle problems. A traditional x-ray only provides a two-dimensional image from which to diagnose foot problems. The new three-dimensional scans allow foot specialists to clearly see how your foot and ankle functions inside your shoes when fully weight-bearing. The new machine can scan both feet, standing in shoes or out, in less than 60 second, to accurately diagnose conditions such as bunions, fractures, dislocations and arthritis.
Below is a guide to the 25 most common cause of foot pain, including bottom foot pain felt in the sole of the foot. These common foot problems are preventable and sometimes reversible with proper care for your feet, as described at the end of the page.
Orthotics are designed to fit in most fashion shoes including high heels, wedges, pumps, boots, sandals and more. Similar to custom-made orthotics, they may have an`S` shape shell cradles the heel and provides full arch support in any shoe, or built-in cushioning under the ball of the foot helps alleviate pressure for increased comfort and protection. Anti-microbial fabrics also protect against odour. See the most recommended orthotic ranges at Boots, Amazon.co.uk and Amazon.com.
Athlete’s foot (tinea pedis) is a fungal skin infection that occurs between the toes. The web between the 4th and 5th toes is almost always involved. If not treated, the fungal infection can spread to the sole and toenails which is more difficult to eradicate. Infection can also spread elsewhere on the body – for example, scratching can infect the finger nails leading to so-called Right hand, Left foot Syndrome in right-handed people. Dry thoroughly between the toes after bathing – use tissue paper or a gentle hairdryer. Apply an anti-fungal cream. Treat for at least 10 days after symptoms improve. Dust with antifungal powder to prevent recurrences.
Blisters occur when rubbing separates layers of skin to form a fluid-filled bubble. Cover with a hydrocolloid gel blister plaster which soaks up fluid and forms a cushioning, healing, antiseptic environment. Do not burst the blister! Draw out fluid with medicinal honey gel (cover and change three times a day). Alternatively, dab calendula ointment or Aloe vera gel on an open blister. These are the best blister plasters from Boots, Amazon.co.uk and Amazon.co.uk.
A bunion (hallux valgus) forms as a bony outgrowth on the inside of your foot at the base of the big toe. Bunions usually form on both feet at the same time and can result from an inherited weakness of the big toe joint, from osteoarthritis, or from wearing shoes that are too narrow and squeeze the toes together. This forces the base of the big toe outwards and is most likely when the weight is forced onto the front of the foot, as when wearing very high-heeled shoes, and when the feet have lost their arches (flat-feet).
The base of the big toe is protected by a fluid-filled sac, known as a bursa, which can become inflamed when a bunion is present to form painful bursitis. If you have a bunion, wear properly fitting, wider shoes. Pads, bunion protectors and toe spacers help to relieve pressure. You may need a custom-made orthotic device to straighten the big toe. Soothe bunion pain by applying an ice pack for a few minutes, then apply Aloe vera gel. See the best bunion relief products at Boots, Amazon.co.uk or Amazon.com.
A callus is a hard, thick patch of skin that can appear anywhere on the feet due to persistent friction from rubbing shoes or from abnormal pressures when walking. They are most common on the heel, ball of the foot and on the toes. Metatarsal pads or soft insole inserts are available to help cushion painful calluses on the sole of the foot. Gently rub with a pumice stone or foot file after soaking in the bath or a foot spa. A rough skin foot scrub can help to keep skin soft. Be very careful if choosing to use a callus removing knife as hard skin is best pared away professionally – and never treat calluses yourself if you have diabetes. Otherwise, wee the best callus treatments at Boots, Amazon.co.uk or Amazon.com.
Chilblains (erythema pernio) are itchy, purple areas of inflammation that can occur on the toes following exposure to cold. They develop when small blood vessels in the skin go into spasm, reducing blood supply to the affected area and causing local cell damage. In severe cases, chilblains can develop into painful blisters. Chilblains are more common in women than men, and are more likely to affect the very young and the elderly.
See the best chilblain relievers at Boots, Amazon.co.uk or Amazon.com.
Claw toe (pes cavus) is a deformity in which the joint of a toe that is nearest the foot bends upwards while the other joints of the toe bend downwards. Claw toe can be present from birth, or be acquired following problems with the spinal cord, or with damage to peripheral nerves in the leg. Clawing can affect any toe except the big toe.
Claw toes are classified according to the mobility of the toe joints. In flexible claw toe, the joint can move and be straightened manually. A rigid claw toe has very limited movement and is often painful. This can limit foot movements and lead to corns and calluses. See the best toe self-help treatments at Amazon.co.uk or Amazon.com.
A clubbed foot (talipes equinovarus) is a congenital deformity in which the heel of one or both feet is turned inwards, and the whole foot bent down (plantar flexed). Milder cases may occur from compression of the foot in the womb, or result from structural abnormalities in which the feet are shorter than normal, and the calf muscles thinner than normal. Treatment involves early correction, within the first year of life, using plaster casts and tendon release (Ponseti method) to realign the feet. Sometimes, surgery is needed to separate and reposition the bones. Individually moulded shoe orthotics will help to maintain foot position and comfort.
Corns (clavus) are a type of callus that form on a toe due to persistent, abnormal pressure on or between the toes. They are a sign that you need to rethink your footwear! Corn pads and creams are available to help soften hard skin, which can dig in to cause pain. Clean with tea tree oil and apply aloe vera gel. Wear a corn plaster if needed to cushion and protect the hardened area of skin. Corn wraps give even greater protection. See the best corn treatment products at Boots, Amazon.co.uk or Amazon.com.
Diabetic foot problems
Foot problems, including infection and ulcers, are one of the main reasons why people with diabetes are admitted to hospital. Diabetic nerve damage (neuropathy) can lead to deformities such as high arches and clawed or hammer toes, which produce abnormal pressures on walking. Reduced sensation also means you may walk more heavily if you feel as if you are treading on cotton wool. And, because of reduced pain sensation, damage such as calluses, rubbing and blisters remain unnoticed and quickly progress to ulceration. Due to poor circulation, healing is poor, waste products accumulate, and tissues become infected, leading to further damage. Reduced blood supply can also mean that prescribed antibiotics do not penetrate the site of infection as well as normal, and gangrene may set in. Sadly, someone with poorly controlled diabetes is 16 times more likely to need a leg amputation than someone without diabetes. Regular foot care to detect early damage is therefore vital. Check feet daily for signs of redness, blisters, cuts or athlete’s foot and seek prompt medical attention. To prevent ulceration and amputation, it is essential to work with your doctor to achieve good glucose control. See the best diabetic foot products at Amazon.co.uk or Amazon.com but always have invasive foot treatments such as paring away skin, done professionally by a healthcare professional.
Drop foot is a symptom of a neuromuscular (nerve and muscle) disorder or injury that affects someone’s ability to raise their foot at the ankle (dorsiflexion). The peroneal nerve is often involved. The foot may appear floppy and the foot must be picked higher up off the ground when walking so the toes do not drag. This leads to a characteristic high-stepping walk (Foot drop Gait). Drop foot occurs in some people with multiple sclerosis, Parkinson’s disease and peroneal nerve injury (e.g. during hip or knee replacement surgery).
Babies are born with a pad of fat filling the longitudinal arch of their feet so all children have flat feet until around the age of three, until the ligaments and muscles in the foot mature. In some people, foot ligaments and muscles fail to develop properly, or an inherited defect in the small bones of the foot allows flat feet (pes planus) to persist. Adults can also acquire flat feet in later life due to fallen arches. This is usually triggered by gaining excessive amounts of weight over a short period of time. The feet may also spread due to extra weight carried during late pregnancy when hormone changes loosen ligaments in preparation for childbirth. See the best flat feet products at Amazon.co.uk or Amazon.com.
Gout is an inflammatory arthritis in which uric acid crystals are deposited in a joint or soft tissues. Gout typically affects a single joint, usually the base of the big toe. It can also affect other joints in the body, including the feet. Symptoms tend to settle within a few days but recurrent attacks are common.
A hammer toe is a deformity of the 2nd, 3rd or 4th toe in which it is bent at the middle joint, to resemble a hammer. This results from shortening of the tendons that control toe movement and is due to badly fitting shoes or neuromuscular problems. Hammer toe often leads to the development of a painful corn on the top of the toe where it rubs against shoes, and a callus on the sole of the foot which makes walking painful. Although initially flexible, a hammer toe can eventually become rigid. See the best hammer toe products at Amazon.co.uk or Amazon.com.
A heel spur is a hook-shaped bony outgrowth that forms on the heel bone (calcaneus) and is often associated with plantar fasciitis. The exact relationship between these two conditions is not fully understood, but inflammation of the plantar fascia may stimulate heel spur formation. They can form without any other foot problems, however, and remain undetected unless the foot is x-rayed.
An ingrown toenail occurs when a spike of nail is overlapped by the surrounding flesh and starts to grow into it, triggering a foreign body reaction with redness, pain and swelling. Infection is common, too. Ingrown toenail is associated with wearing tight-fitting shoes, and with trimming the nails downwards at the corners, rather than straight across. It usually affects the big toe and can occur on both sides. Click here for details of my trick to cure ingrown toenail.
Metatarsalgia is pain in the ball of the foot (where the metatarsal bones are). It is usually felt in the sole of the foot and may feel like you are walking on pebbles. Metatarsalgia is caused by stressing the front of the foot as a result of being overweight, wearing high-heeled shoes, or from deformities such as high arches.
Although a neuroma usually refers to a benign tumour of a nerve, Morton’s neuroma is due to the thickening of tissues surrounding the digital nerve that supplies the toes. This pinches the nerve as it passes under a ligament and typically develops between the third and fourth toes. This condition causes a burning pain and numbness, or unpleasant sensations in the toes, and is sometimes described as like walking on a marble.
Osteoarthritis occurs when the cartilage lining a joint deteriorates and the bone beneath thickens, causing pain, stiffness and swelling. Osteoarthritis can affect any of the 33 joints in either of your feet, but is most common in the joint at the base of the big toes. This is due to the stresses of walking, especially if you over-pronate (ie roll your foot in excessively as you walk). The big toe may eventually become rigid (hallux rigidus) or drift towards the other toes to form a bunion.
The term pigeon toes is used to describe feet that point inwards when you walk. This is common in children and can result from a twisted shin bone, a hip that turns inwards, or turning of the front part of the foot. Most children grow out of pigeon toes.
A plantar wart, most commonly known as a verruca, is a benign skin growth on the soles of the feet due to infection with a human papilloma virus (HPV). When warts form elsewhere on the body, they form mounds. On the soles of the feet, however, the mound becomes flattened into the foot when walking to form a thickening which may be painful. The black threads often seen in the middle of a verruca are not ‘roots’, as is commonly believed, but tiny skin blood vessels (capillaries) that have become compressed and filled with clotted blood. Verrucae are highly infectious, so always get them treated and keep your feet covered. See the best verruca treatments at Boots, Amazon.co.uk or Amazon.com.
Policeman’s foot (plantar fasciitis)
Policeman’s foot, or plantar fasciitis causes pain in the bottom of the foot, mainly under the heel and in the midline. Plantar fasciitis bottom foot pain is due to straining and inflammation of the long, fibrous band (plantar fascia) or tissue that stretches between the heel and the base of the toes. This band is what holds the foot bones together ot maintain the shape of your foot arches. In some people, plantar fasciitis is associated with growth of a bony spur on the heel bone. Pain typically occurs after getting up, then improves as the foot flexes during walking. Discomfort also occurs in the arch of the foot after prolonged standing or walking. See the best treatments for plantar fasciitis at Boots, Amazon.co.uk or Amazon.com.
Pronation describes the motion of the foot once it strikes the ground. Normally, the outside of the heel should touch the ground first, and then the foot rolls inwards, or pronates, as the foot flattens out, by 4% to 6%. If overpronation occurs, the tibia is forced to twist slightly in the opposite direction, which stretches the calf muscles and can lead to shin splints. Women are more prone to over-pronation as they have wider hips, and their feet strike the ground at a greater angle. Select shoes such as trainers that have in-built anti-roll devices to reduce over pronation. See the best pronation correcting products at Amazon.co.uk or Amazon.com.
Rheumatoid arthritis is an autoimmune condition in which the synovial lining of joints become swollen, painful and stiff. Most people with rheumatoid arthritis develop foot problems with pain in the sole or ball of the foot. Claw toe and hammer toe are also common. If the hindfoot and ankle are affected, the longitudinal arch of the foot may collapse to cause flat feet.
Shin splints is the common name for a dull, aching pain in the lower front of the tibia, usually resulting from exercise, especially running. The pain can radiate down to the feet. Shin splints is not a diagnosis in itself as it can be due to a number of different causes, including overuse of muscles, inflammation of the sheath (periosteum) surrounding the tibia bone, tight tendons, and excessive pronation. See the best shin splint relieving products at Amazon.co.uk or Amazon.com.
A sprain is an injury to a ligament caused by sudden overstretching. Most ankle sprains are due to rolling the foot inwards, which stretches or tears the ligaments binding the ankle and foot bones together. This is called an inversion sprain. The less common eversion sprain occurs when the foot suddenly turns outwards, which damages ligaments on the inside of the ankle. Apply an ice-pack to a sprain as quickly as possible. Either use hot-cold packs designed to be frozen, or wrap a bag of frozen peas or ice-cubes in a towel or cloth and apply to the area for 10 minutes at a time, then remove for a few minutes before repeating. Don’t place ice directly on the skin as this can cause a cold burn. Elevating the leg will help to reduce swelling. Place a cushion under the heel rather than under the calf for support. An elasticated compression bandage will also help to minimise swelling. This is best applied by someone with first aid training, as a bandage that is too tight will do more harm than good. Signs that a bandage is too tight include pins and needles, pain, blueness or numbness in the lower leg. See the best sprain relieving products at Boots, Amazon.co.uk or Amazon.com.
Tarsal tunnel syndrome
The tarsal tunnel is a narrow space on the inside of the ankle which is covered with a thick ligament (flexor retinaculum). The posterior tibial nerve passes through this tunnel (along with arteries, veins and tendons) and is easily compressed if space is tight – especially if you have flat feet. Tarsal tunnel syndrome causes tingling, burning, numbness or shooting pains on the inside of the ankle or on the bottom of the foot and the pain may extend upwards into the calf. Symptoms can appear suddenly but usually come on after prolonged standing, walking or exercising. See the best tarsal tunnel pain products at Amazon.co.uk or Amazon.com.
Tired achy feet
Tired feet are inevitable after standing or walking all day. Treat your feet to a luxurious soak in a bubbling foot spa, or a solution containing Dead Sea salts. Moisturise with a foot cream/butter afterwards, and trim your nails straight across while you’re at it. Supplements containing Red Vine Leaf extracts or Pycnogenol (French maritime pine bark extracts) are helpful for aching legs and feet. See the best treatments for tired feet at Boots, Amazon.co.uk or Amazon.com.
Dealing with painful feet
- Exercise your feet and maintain their flexibility by circling your feet ten times in each direction, keeping your leg as still as possible.
- Roll a tennis ball, golf ball or foot exerciser under the sole of your foot.
- Another good exercise is to practice picking up a pencil with your toes.
- If standing all day, try to move about or flex the feet up and down.
- At home, walk around bare-footed on safe flooring (without risk of slipping or splinters).
- Use a foot file, emery board or pumice stone to keep hard skin and calluses at bay – these are easiest to use after soaking your feet in a foot bath.
- When buying shoes ensure there is enough room to wiggle your toes.
- Put your feet up as often as you can – 10 minutes elevation after a long day helps circulation.
- Apply a foot lotion to keep the skin of your feet moist and supple.
- Use gel insoles for extra foot comfort. Toe and ball foot cushions help to gently align toes – especially where they have been crushed by pointy shoes. Molded arch supports help to keep the arch bones in their natural position. Full and three quarter length insoles support the arches, heels and balls of the feet – ideal for shock absorption. Anti-fatigue cushions are soft gel cups that cushion the heel, helping to relieve knee and lower back pain.