Foot pain and disorders are common concerns for older people. These pains make 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. But just because you are getting older, you do not have to tolerate foot pain. Being able to walk well is extremely important, since walking is one of the best ways to exercise and keep fit.

Most foot problems can be treated effectively. A podiatrist can diagnose your condition, and choose the appropriate treatment. You do not have to suffer needlessly.

What are Foot Problems?

Decades of standing change your feet. You lose much of the natural cushion of padding under your heel, and the ball of your foot. Your arches get flatter and less flexible; 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 issues.

How Common are Foot Problems?

One in three persons over the age of 65 has foot pain, stiffness, or aching feet. Older people who live 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 derive 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; 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.

 

Causes

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; those that offer no protection or support; these could all cause serious injury and pain, increasing your chance of a fall.

As you age, not only do your feet tend to spread, and lose the fatty pads that cushion the bottom of your feet, but if you have extra weight, the bones and ligaments are affected more. Additionally, any abnormalities that you were born with, can become more pronounced or painful as your foot joints lose their flexibility, and become more rigid with age. The skin of your feet also gets drier with age, which means that infections can occur more easily.

Monitoring

You should inspect your feet regularly. Check for changes in skin colour or temperature; thickened or discoloured nails; and any sign of a break in the skin, or an abrasion.

Older people with diabetes make up the greatest proportion of older adults with serious foot disorders. For these people, it is essential to get a thorough foot evaluation at least once a year. Many older people particularly those with diabetes have impaired vision. This can make it harder to find small changes or skin problems. If your vision is not adequate, find a podiatrist or other trained healthcare provider who can check your feet regularly. If you have diabetes and your circulation to your feet is impaired, or you have foot problems, you will likely need to see a podiatrist approximately every 3 months.

Diet and Exercise

If you have diabetes, the health of your feet depends a great deal on how well you can control your blood sugar. A healthy diet is crucial. Follow your dietitian or healthcare provider’s recommendations. Eat plenty of fresh fruits and vegetables; complex carbohydrates; and low-fat proteins, rather than refined foods and sweets. Make sure your fluid intake is adequate. Remember to take your medications at the right times, if prescribed.

Regular, gentle, low-impact exercise, especially walking, stretching, swimming and bicycling will help keep the muscles, tendons, and ligaments of your feet flexible and healthy.

Complications

Foot problems can lead to:

• An increased risk for falls and fractures
• Reduced mobility, independence, and ability to carry out daily functions
• Chronic pain
• Amputation
• Decline in general health due to restrictions on exercise
• Lower quality of life
• Decreased heart function
• Higher risk of hospitalisation and long-term care.

Your feet mirror your general health . . . cherish them!