Identifying Causes and Types of Foot Pain in Adults

Obesity, high heels and high-impact activity all play a role in causing foot pain. Local doctors share their insights for coping with various pain-related issues.



Our feet have more bones, muscles, and ligaments than any other part of our bodies, so it’s no surprise that 75 percent of us will experience foot pain at some point in our lifetimes. What many don’t realize is that our feet are pretty good indicators of overall health and wellness. Signs of serious conditions, like diabetes, arthritis, and circulatory disorders, can first be detected in our feet, so it’s important to take proper care of them, especially if you’re in a profession that requires lots of standing or walking. Nurses, hair stylists, waiters, and retail workers are more prone to foot pain than those who don’t spend as much time on their feet. Some foot pain may be inherited, but, according to the American Podiatric Medical Association, the most common causes are ill-fitting shoes, high-impact activity, obesity, and the cumulative effects of stress and abuse.

Heel Pain
Both Josef Geldwert, DPM, a podiatrist at The Center for Podiatric Care and Sports Medicine in White Plains, and Michelle Castiello, DPM, of Westchester Podiatry Associates in Eastchester, say that heel pain is the number-one patient complaint. This pain is commonly caused by plantar fasciitis, an inflammation of the connective tissue that runs inside the foot, from the heel to the ball. “It’s a common affliction among active 20- to 50-year olds,” Dr. Castiello says. “However, in recent years, I see more cases in young teens who play multiple sports and older people who have continued to work past retirement age.” Plantar fasciitis, usually due to repetitive impact activity, is common in runners and those who stand on their feet all day, and can be exacerbated by wearing shoes without good support.

The good news: Conservative measures—like stretching the calf muscles, icing, anti-inflammatory medicine like ibuprofen, or wearing orthotics—often can reduce or eliminate pain caused by plantar fasciitis, suggests Dr. Castiello. But, for some, the solution isn’t so simple. In extreme cases, Dr. Geldwert and John C. Marzano, DPM, of Westchester Podiatric Medicine in Hartsdale and Yonkers, have used extracorporeal shock wave treatment (ESWT), a non-invasive procedure that sends acoustic sound waves into the foot to stimulate muscles and healing. Barbara Prisament of Hastings used a combination of ESWT, orthotics, and physical therapy to help alleviate her pain. It not only worked, but she thanks her plantar fasciitis for changing her health. “I needed to take the pressure off my feet,” she says, “so I changed my diet and lost weight.”

Osteoarthritis
Osteoarthritis, common among active adults, is the culprit that causes breakdown and eventual loss of cartilage. For many, the condition is inherited and may be symptomatic of other more serious conditions like diabetes, hormone disorders, or congenital abnormalities, but for some, it is the result of injury, obesity, or prolonged wear and tear. Long-distance runner Robin Arnold of Purchase went to Dr. Geldwert in extreme pain. He diagnosed osteoarthritis in her big toe, the most common form of the condition in the foot. Treatment can include taking anti-inflammatory medication, physical therapy, bracing and casting, or, like Arnold, Synvisc injections (a lubricant generally used for arthritic knees) and new orthotics. In addition to being able to resume her daily life, Arnold went on to climb Mount Kilimanjaro and run the ING New York City Marathon.

Bunions
Bunions, bone deformities that cause the toe joint to enlarge and move out of place, can eventually lead to arthritis. Dr. Castiello asserts that bunions are usually caused by a genetic component, and wearing improper shoes can aggravate them. “If we can control the foot structure by wearing proper shoes and orthotics, we can slow down the deformity.” The constant rubbing and friction of a bunion in your shoe makes it difficult to walk, let alone exercise. For many, traditional solutions like inserting padding into shoes, icing, and wearing proper shoes (women, take note: the ideal heel size is 1 to 2 ½ inches; anything higher may cause or exacerbate bunions) can help alleviate pain caused by bunions.
But if you’re like Yonkers resident Dorothy Gill, whose bunion caused her extreme burning and pain even when sitting, the answer may lie in bunion-removal surgery. The most recent advancement is the “mini-tightrope” surgery, which was successful for Gill. The procedure, an alternative to traditional bunion-removal surgery, corrects the foot without cutting completely through the bone. But Dr. Geldwert cautions, “Not one specific bunion-removal surgery works for everyone.”

Elana Krasner lives in Brooklyn and works in marketing/PR for the International Council of Shopping Centers.