As winter approaches and we squeeze our feet back into boots and shoes, we may get an unwelcome reminder of foot problems.
There are many factors that cause foot pain, from hereditary arthritis to ill-fitting shoes, high heels and fungal infections. Here are some of the common ones and how to remedy them, so you can enjoy your new boots in comfort.
Lumps and bumps
Swollen, painful bumps on toes or the side of your foot can get worse if your shoe rubs against them. There are two main causes of feet deformed by bunions and misshaped toes, which can lead to pain. The first is hereditary, as bunions and arthritis tend to be, while the shoes you wear can cause and exacerbate problems.
BUNIONS are a deformity of the big toe joint, where a painful bony growth juts out on the joint at the base of the big toe, which forces the big toe to turn in at an angle towards the other toes.
BUNIONETTES are a painful swollen lump on the outside of your foot near the base of your little toe. You may also have a hard corn and painful bursitis in the same spot.
HAMMER TOES, also known as claw toes, are where the middle joints in the toes start to curl downwards, so the toes are bent. The smaller toes are particularly susceptible when you wear pointy shoes. Painful corns can form on top of the toes that are pushed up, or on the tip of a toe, while extra pressure is put on the ball of your foot, which can result in calluses.
- Swapping between different styles of shoe can take the stress off your feet, by helping to avoid problems with pressure points.
- Experts don’t recommend any heels higher than 2ins, and these should only be worn for a few hours at a time.
- Bunion plasters and toe separators can be bought from pharmacists, which act as a shock absorber and reduce friction, but they don’t cure the problem, just make you feel more comfortable.
- Bunions tend to form after the big toe starts to move inwards. In the early stages you may be able to remedy this with exercises, such as sitting down, placing your feet side by side, and looping a thick elastic band around your big toes. Slowly pull your feet apart to tighten the elastic. Hold for 20 seconds. Repeat 10 times. Do three sets once a day, every day, to maintain the improvement.
A stiff big toe
If you have a stiff and painful big toe, that over time may even become fixed rigid, this could be caused by osteoarthritis. This tends to happen because we use our big toe to push off every time we take a step. The wear and tear causes the joint’s cartilage to wear down.
- Wearing shoes with a bit of space for your toes helps, as does having shoes with rigid soles, to keep your big tore from twisting and bending.
- Exercises can help you regain a range of motion. Put a towel on the floor and use your toes to grip the towel and move it towards your heel. Repeat 5 times. Do this 3 times a week until symptoms ease.
- Your doctor may be able to prescribe shoe inserts, or reduce pain with medication, such as ibuprofen or a cortisone injection, which an experienced foot doctor can administer.
When to see a doctor about your feet
Mr Haroon Mann, a Consultant Trauma and Orthopaedic Surgeon, says that many people are still reluctant to consult a doctor about their feet, even when they are in persistent pain, but this is what they should be doing.
Treatments available include, cortisone injections to manage pain and increase movement, Extracorporeal shockwave therapy (ESWT) and platelet-rich plasma (PRP) injections, to speed healing.
Nitroglycerin cream applied to the overlying skin. It relaxes blood vessels and allows blood to flow more easily to the area.
Sometimes day surgery is the best option. Whether your toes would look, and feel, better shorter, longer, or straighter, an orthopaedic surgeon is the person to advise you.
‘I believe we should have the freedom to wear the shoes that they want to wear. Whether you'd rather wear heels or flats, I love enabling people to make that decision, and take pain out of the equation,’ adds Mr Mann.
As we age we’re more likely to develop thick toenails, one of the most common foot problems, which is often caused by a fungal infection. In some cases, the nail can become painful and come away from the toe bed.
Fungi invade and grow in dead keratin, a protein that makes up your skin, hair and nails. Common fungal infections include:
Athlete’s foot (Tinea pedis) is caused by a fungus that grows in warm, damp areas of skin, such as between your toes, and affects one in six people.
Nail infections (Tinea unguium), usually start at the edge of your nail and spread slowly down to the base. They cause your nail to discolour and become crumbly. The surrounding tissue may also get thicker. Toenails are usually affected more than fingernails.
- An expert dermatologist is best qualified to diagnose your condition.
- They will be able to prescribe an antifungal treatment, such as a topical cream or oral medication to fight the infection.
- To manage the infection, it’s important to thoroughly dry your feet, especially between the toes, after showering.
Pain under your feet and heels
Plantar fasciitis, or ‘heel spur pain’, is the most common cause of pain under the bottom of your feet and heels when tissues become inflamed. Patients often say they experience pain when they first get out of bed in the morning.
If you don't treat plantar fasciitis, it may become a chronic condition. The frequency and intensity of the pain may increase, even when doing every-day activities like walking. You may try to compensate by changing the way you walk, which in turn can lead to other foot, knee, hip and back problems.
‘Many people try to ignore the early signs of heel pain and keep on doing the activities that caused it,’ says Mr Mann. ‘If your heel hurts, make an appointment to see an orthopaedic doctor right away to determine why and get treatment.’
• A doctor can prescribe anti-inflammatory painkillers to reduce swelling, like ibuprofen or naproxen.
• Support your foot by wearing a heel pad inserts in your shoe.
• A cortisone injection to relieve nerve pain.
• Extracorporeal Shock Wave Therapy (ESWT) helps heel pain, as pulses of energy promote the growth of new blood vessels, which speeds heeling and reduces nerve pain.
Pain behind the heel
Pump bump can be caused by exercise, or wearing shoes with rigid backs or straps, creating a bony enlargement.
- You may need an X-Ray to see if you also have a bone spur, where calcium deposits form where the foot tissue connects to your heel bone.
- Treatment for inflammation may involve medication or cortisone injections
- Shoe inserts can support the foot and ease pressure.