Written by Kim Grundy, PT | Reviewed by Mandy Armitage, MD
Published on May 16, 2024
Key takeaways:
Foot problems are more likely to occur as you age. You may experience issues due to changes in your foot structure, including loss of the fat pad, joint stiffness, decreased muscle strength, or flattening of the arch.
People with foot pain have a higher chance of falling and having an altered gait. They are also typically less active than people who don’t have foot pain.
There are several ways to keep foot problems from worsening. Wearing well-fitting shoes, and doing foot-strengthening exercises and stretches may help.
simarik/iStock via Getty Images PlusYour feet play a significant role in your daily life. They support your weight, keep you balanced, and enable you to walk, run, and jump. As you age, taking care of your feet becomes even more crucial. Preventing or treating common foot problems helps ensure you can continue to enjoy your favorite activities.Made up of 26 bones and 29 muscles, as well as nerves, ligaments, and tendons, the foot is a rather complicated structure with many moving parts. Research has found that people with foot pain or stiffness are less active, sit more, and tend to have an altered walking pattern. Foot problems also more than double your risk of falling, which is of particular concern as you get older.
Common foot problems in older adults
Americans take an average of 5,117 steps per day, which means your feet experience wear and tear over time. They also go through several physical changes as you age, which makes you more prone to common foot problems.
As you age, your feet may change in the following ways:
Widening of the feet
Flattening of arches
Decrease in and stiffening of fat padding in the soles
Stiffening of joints
Decrease in shock absorbency provided by the feet
Decrease in muscle mass and strength
Thinning and drying of skin
Below, we look at nine of the most common foot problems that happen as you age, as well as treatment and prevention strategies.
Arthritis
Arthritis, which causes pain and inflammation in the joints, is a common foot condition in older adults. Any type of arthritis can affect your feet, but the three most common are:
Osteoarthritis, which is caused by wear and tear” of the joints)
Rheumatoid arthritis, an autoimmune disease
Post-traumatic arthritis, which is caused by injury
Symptoms of foot arthritis include stiffness, pain, and swelling. The pain is often worse with activity. It may also be worse in the morning or after a period of inactivity.
There is no cure for arthritis, but there are some treatment strategies that may help. These include:
Avoiding high-impact activities, like jogging, jumping, or tennis, and opting for lower-impact activities, like walking, cycling, or yoga
Maintaining a healthy weight to reduce stress on the joints
Doing foot and ankle exercises (with the help of a physical therapist) that address flexibility and range of motion, as well as doing strengthening exercises
Using assistive devices such as shoe inserts, orthotics, or a brace (like an ankle-foot orthosis) to help support joints and improve mobility
Taking an over-the-counter medication, such as a nonsteroidal anti-inflammatory drug (NSAID), or using creams or patches to help relieve pain and swelling
If conservative measures don’t help, however, it’s best to talk to a healthcare professional. A steroid injection, a prescription medication, or surgery may be an option.
Bunions
Bunions are one of the most common foot conditions that can occur as we get older. A bunion appears when the big toe leans in toward the other toes and a bump develops on the joint of the big toe. Bunions, also called hallux valgus, often run in families and are more common in women. Other risk factors include having a tight Achilles tendon, a joint condition such as rheumatoid arthritis, flat feet, or weak connective tissue. Wearing narrow shoes and high heels can also worsen or speed up the progression of bunions.
The symptoms of bunions range from mild discomfort to severe pain and toe numbness. And because of how the big toe is bent, it can crowd and affect the other toes, causing hammertoes or corns.
Though they won’t correct the misalignment or bump, these conservative measures may relieve pain related to bunions, according to a 2022 meta-analysis:
Wearing proper shoes: Wear flat shoes that give your toes plenty of space to move around. You can also use shoe inserts or bunion pads in your shoes to get relief.
Walking barefoot: Spend some time without shoes on to strengthen your foot muscles and allow your toes and feet to be in their natural alignment.
Using splints: Toe spacers or splints can be worn at night to relieve symptoms and slow down the progression of bunions. They won’t correct an existing bunion, but they may prevent it from getting worse.
Doing physical therapy: A physical therapist can develop a treatment program consisting of manual therapy, taping, and foot exercises for bunions. They can also recommend a splint to help relieve the symptoms.
Correcting the misalignment through surgery is the only way to treat the source of bunion symptoms.
Hammertoe and claw toe
Hammertoe and claw toe are foot deformities that affect all of the toes except the big toe. These issues are often caused by an imbalance between the muscles that bend the toes and the muscles that keep them straight. This can be caused by ill-fitting shoes and certain medical conditions that affect the muscles or nerves. Due to genetics, some people are more at risk for these foot issues, as well.
Hammertoe causes the middle joint to bend, so your toe looks like it is bending down. It often only affects the second toe. And it commonly happens along with bunions. Claw toe often affects the four smaller toes at the same time. In an affected toe, the last joint bends down, causing them to develop a claw-like appearance.
Symptoms of hammertoe and claw toe include toe pain, swelling, and redness. It causes difficulty straightening an affected toe. And there’s a chance you may not be able to straighten it at all. Corns or calluses will often develop. You may also have difficulty walking.
With both conditions, you can move an affected toe at first. But it’s important to start treatment right away to prevent the joint from hardening into a bent position. Treatment strategies for hammertoe and claw toe include:
Doing toe stretches and exercises: Use your hands to stretch your toes into a straightened position. Strengthen your toes and improve their mobility by picking marbles off the floor or crumpling a towel with your foot.
Using splint or tape: Talk to your healthcare professional or physical therapist about using tape or splints to hold your toe in the correct position.
Wearing the proper shoes: Avoid tight, narrow shoes and high heels. Supportive sandals that give your toes plenty of space are a good option.
Having surgery: Surgery may be needed in some cases.
Corns and calluses
Both corns and calluses are caused by friction that thickens the skin. Corns develop due to bones pressing against the skin. And they often appear on the top of, between, or on the outer edges of toes. They are smaller than calluses and have a hard center that is painful when pressed. Calluses can develop anywhere on the hands and feet. And they are usually not painful.
Wearing shoes that don’t fit properly and having toe deformities (like the ones listed above) increases the risk of corns and calluses.
Corns and calluses usually go away once the friction or pressure that caused them disappears. The following strategies may also help:
Soak calluses or corns in warm water for 5-10 minutes. And then use a pumice stone to gently remove hardened and dead skin.
Apply lotion that has salicylic acid, ammonium lactate, or urea daily to soften the hardened skin.
Use a pad to prevent friction and pressure on calluses or corns.
Keep your toenails trimmed to prevent them from pressing against your shoes and affecting the alignment of your toes.
Diabetes-related foot complications
Diabetes can cause many foot problems because of how the disease affects the nerves and circulation. Some examples of these foot problems include:
Diabetic neuropathy: Diabetic neuropathy is nerve damage that causes pain, tingling, and loss of feeling in the feet. It can be particularly dangerous to lose feeling in the feet because sores, cuts, and other injuries can go unnoticed and lead to a serious infection or injury.
Decreased blood flow to the feet: This makes infections and injuries take longer to heal. It can lead to foot ulcers or gangrene, which may require the toe or foot to be amputated to prevent the infection from spreading.
Charcot foot: Both diabetic neuropathy and circulation issues can change the shape of the foot, causing a condition called Charcot foot.
To help your feet stay healthy and avoid serious complications, keep the following foot care tips in mind:
Check your feet daily for scratches, cuts, red spots, blisters, corns, and other injuries. Use a mirror as needed. If you have difficulty checking your feet, ask someone else to do it for you. If you see any injuries, check in with a podiatrist (foot doctor) or your regular healthcare provider right away.
Wash your feet every day in warm (not hot) water and put talcum powder between your toes to keep moisture away.
Wear well-fitting shoes with lightly padded socks at all times to protect your feet. This is especially important if you have lost feeling in your feet.
Cut your toenails straight across to prevent ingrown toenails that can lead to a serious infection.
Increase blood flow to your feet by keeping your feet elevated and wiggling your toes throughout the day. Try to walk around or do heel raises at least once an hour. Do not wear tight socks that constrict blood flow.
Fungal infections
Fungal infections are a common foot issue. You can get a fungal infection if your foot comes into contact with a contaminated surface, often in a moist environment like a shower or spa. The most common foot fungal infections that affect older adults are toenail fungus (onychomycosis) and athlete’s foot (tinea pedis).
Toenail fungus often affects people with diabetes or a weakened immune system, as well. Symptoms of toenail fungus include yellowing, thickening, and flaking of the toenail. The nail plate may also be rippled, and the nail may separate from the nail plate.
Athlete’s foot is a highly contagious fungal infection that is also passed through contact with floors or footwear. Symptoms of athlete’s foot include itching, burning, and peeling of the skin. This often affects the skin between the toes, but it can also occur on the soles or heels.
It can take a long time to treat toenail fungus. The most effective way to address it is by taking oral medication for up to 12 weeks. Topical creams often aren’t effective because they aren’t absorbed past the nail plate. Even with treatment, it can take up to a year for the nail to return to its normal color and texture.
Treating athlete’s foot is a bit easier than treating toenail fungus. The treatments include over-the-counter creams, lotions, and powders. But prescription antifungal medication can help if topical forms don’t work.
You can help prevent fungal infections by keeping your feet dry and not going barefoot in spas, locker rooms, or public showers.
Gout
Gout is a type of inflammatory arthritis that can affect the foot. It often affects the big toe, specifically. The condition occurs because of too much uric acid in the body, which causes crystals to form around the joints.
Symptoms of gout include intense pain, swelling, and redness in the skin around the affected joint. Gout symptoms often come and go. Flare-ups may peak for 12 to 24 hours, before slowly going away in a week or two.
Gout is usually triggered by eating certain foods (such as red meat or seafood), drinking alcohol or sugary sodas, or taking certain medications. It’s more common with age and for people who have certain medical conditions, such as high blood pressure and chronic kidney disease. Gout is also more likely to affect people with a family history of the condition.
Treatment for gout includes taking anti-inflammatory and uric-acid-lowering medications, which are very effective. Changing your diet to remove or reduce alcohol, red meat, and shellfish is also helpful. Research suggests that a low-fat, low-carb, and plant-based diet is beneficial for people with gout. The DASH diet or Mediterranean diet are two good options.
Heel pain and plantar fasciitis
Plantar fasciitis is the most common cause of heel pain in adults between the ages of 40 and 60. It occurs when the strong band of tissue that supports the foot, called the plantar fascia, becomes strained or irritated. This can be caused by standing for long periods, weight gain, long-distance running, or wearing shoes with poor arch support.
One of the primary symptoms of plantar fasciitis is heel pain, which is often worse in the morning or after a period of inactivity. The pain often lessens with movement. A heel spur, which is a calcium deposit on your heel, may also develop at the same time as plantar fasciitis.
Treatment for heel pain from plantar fasciitis includes:
Taking a break from activities that increase your pain
Applying ice and taking anti-inflammatory medications for pain relief
Doing exercises to stretch and strengthen your foot
Wearing orthotics to help support your foot or provide cushion to your heel
Having surgery in rare cases
Acquired flatfoot
The structures in the feet that form your arches weaken with age. In particular, the posterior tibial tendon, which runs along in the inside of the foot and behind the ankle bone, is subject to overuse and stress over time. This can lead to pain, flattening of the arches, and visible changes in the shape of the feet, including acquired flatfoot. Acquired flatfoot is most common in women over the age of 40.
Treatment for acquired flatfoot includes:
Physical therapy to strengthen the foot and ankle and improve balance
Bracing or custom orthotics
Surgery in severe cases
The bottom line
Due to changes in your foot structure over time, you are more at risk for developing foot problems as you get older. Taking care of your feet and starting treatment early can help prevent foot conditions from turning into a bigger problem. Wearing well-fitting shoes is also important. And staying active and walking more is beneficial to your joints, as well as your overall health.
References
American Academy of Dermatology Association. (n.d.). How to treat corns and calluses.
American Academy of Orthopaedic Surgeons. (2012). Claw toe. OrthoInfo.
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