WHAT ARE THE GENERAL CAUSES OF FOOT PAIN?

Nearly all causes of foot pain can be categorized under one or more of the following conditions.

• Shoes. The causes of most foot pain are poorly fitting shoes. High-heeled shoes concentrate pressure on the toes and are major culprits for aggravating, if not causing, problems with the toes.
• Temporary Changes in Foot Size and Shape. Temperature, and therefore weather, affects the feet: they contract with cold and expand with heat. Feet can change shape and increase in size by as much as 5% depending on whether a person is walking, sitting, or standing.
• Poor Posture. Improper walking due to poor posture can cause foot pain.
• Medical Conditions. Any medical condition that causes imbalance or poor circulation can contribute to foot pain.
• Inherited Conditions . Inherited abnormalities in the back, legs, or feet can cause pain. For example, commonly one leg is shorter than the other, causing an imbalance.
• High-Impact Exercising. High-impact exercising, such as jogging or strenuous aerobics, can injure the feet. Common injuries include corns, calluses, blisters, muscle cramps, acute knee and ankle injuries, plantar fasciitis, and metatarsalgia.
• Industrial Cumulative Stress. Because of the effects of work-related repetitive stress on the hand, there has been considerable interest in the effect of work-stress on foot pain. According to one 2000 analysis, there is very little evidence for any significant impact of work on various foot disorders, including hallux valgus, neuroma, tarsal tunnel syndrome, toe deformity, heel pain, adult acquired flatfoot, or foot and ankle osteoarthritis. In general, the foot is designed for repetitive stress and few jobs pose the same stress on the feet as many do on the hands. Nevertheless, certain professions, such as police work, are associated with significant foot pain. More research is needed.

Women are at higher risk than men for severe foot pain, probably because of high-heeled shoes.

Older Women . Severe foot pain appears to be a major cause of general disability in older women. In one study, 14% of older disabled women reported chronic, severe foot pain, which played a major role in requiring assistance in walking and in daily activities.

Pregnant Women. Pregnant women have special foot problems from weight gain, swelling in their feet and ankles, and the release of certain hormones that cause ligaments to relax. These hormones help when bearing the child but can weaken feet.

Medical Conditions Causing Foot Pain

Arthritic Conditions. Arthritic conditions, particularly osteoarthritis and gout, can cause foot pain. Although rheumatoid arthritis almost always develops in the hand, the ball of the foot can also be affected.

Diabetes. Diabetes is an important cause of serious foot disorders. It is discussed in a separate section. [See Box Diabetes and Foot Pain.]

Diseases That Affect Muscle and Motor Control. Diseases that affect muscle and motor control, such as Parkinson's disease, can cause foot problems.

High Blood Pressure. High blood pressure can cause fluid build-up and swollen feet. The effects of high blood pressure on the nervous and circulatory systems can cause pain, loss of sensation, and tingling in the feet, and can increase the susceptibility for infection and foot ulcers.

Osteoporosis. Osteoporosis, in which bone loss occurs, can cause foot pain.

Pregnancy. Pregnancy can cause fluid build-up and swollen feet. The increased weight and imbalance of pregnancy contributes to foot stress.

Other Diseases. Diseases that affect the nervous and circulatory systems, such as anorexia, can cause pain, loss of sensation, and tingling in the feet, as well as increase the susceptibility for infection and foot ulcers. A number of conditions, including heart failure, kidney disease, and hypothyroidism, can cause fluid build-up and swollen feet.

Medications. Some medications, such as calcitonin and drugs used for high blood pressure, can cause foot swelling.