Do Your Feet Hurt?

Symptoms

• Tingling, burning or numbness on the ball of your foot between the third and fourth toe.
• Discomfort or pain that starts out only occasionally, but eventually persists for days or weeks at a time.

Causes

The nerve between the third and fourth toe becomes irritated and then painful, but the exact cause of the irritation is unknown. Common offenders seem to be tight shoes and high heels that compress and irritate the nerve. Certain foot problems such as bunions, flat feet, hammer toes or high arches may also play a role.

What you can do

• Wear wider shoes with lower heels and a soft sole, which allow the bones to spread out, relieving pressure on the nerve.
• Use an ice pack on the affected area for 20 minutes several times a day to reduce swelling.
• Stay away from activities that put repetitive pressure on the neuroma, such as tennis or jogging, until the condition improves. Now is a good time to try yoga or Pilates instead.

What your doctor can do

Your doctor can show you how to pad your foot or may prescribe custom orthotic devices for your shoe to reduce pressure on the nerve. If necessary, cortisone injections into the affected area of the foot help to relieve the inflammation. The injections are given every two months until the condition improves, up to a maximum of three shots. If these treatments don't work, you may need surgery either to remove the nerve or the thickened tissue around the nerve. Full recovery may take as little as four weeks, but it depends on the specific procedure.

3. Plantar Fasciitis

A tough, protective ligament (the plantar fascia) that runs from the heel bone to the base of the toes acts as a shock absorber and support for the arch of the foot. Over time, small tears develop and the tissue becomes inflamed. This condition is called plantar fasciitis.

Symptoms

• Mild pain on the bottom of the foot near the heel.
• A sharp, shooting pain in the heel when you first step down on your foot in the morning, which subsides after a few minutes of walking.
• Heel pain after, not during, exercise.

Causes

You're more likely to develop plantar fasciitis if you have high or low arches; are obese, overweight or gain weight suddenly; have tight Achilles tendons; or wear shoes with poor arch support or soft soles.

What you can do

• Increase the flexibility of the Achilles tendon and plantar fascia with stretching exercises.
• Wear shoes that are supportive and well-cushioned.
• Roll your foot over a chilled or frozen bottle of water for 15 to 20 minutes several times a day to reduce inflammation.
• Try to drop some pounds if you're overweight to relieve pressure on your feet.

What your doctor can do

Your doctor may recommend heel pads or shoe inserts to reduce the pain. Injections of cortisone into the ligament — every two months for a total of three shots max — can relieve inflammation. A night splint to stretch the plantar fascia is effective and, although difficult to sleep with, doesn't have to be used once the pain is gone. If you have severe chronic plantar fasciitis that doesn't respond to traditional treatments, your doctor may consider an injection of platelet-rich plasma (PRP). In this procedure, your own blood's platelets are used to kick-start healing. Treatments are Food and Drug Administration-approved, but may not be permanent and insurance doesn't cover the often considerable cost. Your doctor may also prescribe visits to a physical therapist.

4. Toenail Fungus

Chances of developing a toenail fungus increase with age; an estimated 50 percent of men and women are affected by this nasty condition by age 70.

Symptoms

• Loosened or lifted nail
• Crumbly, ragged or thickened nail
• Streaks or spots down the side of the nail
• Dark color, caused by buildup of debris under the nail

Causes

You risk developing a toenail fungus if: your feet perspire heavily or you wear tight shoes; you walk barefoot in public showers, swimming pools and gyms; you have minor nail or skin injuries that provide a convenient entry for the fungus.

What you can do

• Wash your feet regularly and dry them thoroughly.
• Wear socks made of synthetic fiber, which wick away moisture better than cotton or wool socks.
• Soak your feet daily in a mixture of one part white vinegar to two parts warm water for 15 to 20 minutes. Rinse well and pat your feet dry. If your feet become irritated, cut down to two or three times a week.
• Apply a small amount of Vicks VapoRub to the affected nail once daily, using a cotton swab or your finger. A small study shows an 83 percent improvement after 48 weeks.

What your doctor can do

Your doctor may prescribe an antifungal cream to use on the nail itself or one of the newer antifungal drugs you take by mouth. Laser therapy for toenail fungus is a relatively new method and long-term data on its effectiveness are lacking. In addition, it can be expensive — about $1,000 — and it's not covered by insurance. In severe cases, you may need surgery to remove the nail, but it will grow back.

Who's Taking Care of YOUR Feet?

Podiatrist
Podiatrists specialize in the medical and surgical care of the foot, ankle and lower leg. They complete four years of podiatric medical school to earn the degree of Doctor of Podiatric Medicine and then go on to two or three years of accredited postgraduate medical and surgical residency.

Orthopedic Surgeon
Orthopedic Foot and Ankle Surgeons specialize in the treatment of the foot and ankle. They complete four years of medical school to earn the degree of Doctor of Medicine or Doctor of Osteopathy and then go on to four or five years of accredited postgraduate medical and surgical residency. After they complete residency training, both podiatrists and orthopedic surgeons are eligible for board certification, which requires passing an exam to assess medical knowledge and clinical judgment.

If the Shoe Fits

Shoes that don't fit properly are a major cause of these common foot ailments. "Although feet continue to change with age, very few adults have their shoe size checked regularly" says Steven D.K. Ross, MD, clinical professor of orthopedics at the University of California, Irvine. "Arches tend to drop with time, so they get longer and the forefoot grows wider. Yet people are likely to wear the same size shoe they did when they were adolescents. Then they wonder why their feet hurt and they have problems with them." So have your feet measured at least once a year when you shop for shoes.