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The foot is a complex structure of 26 bones and 33 joints layered with an intertwining web of 126 muscles, ligaments,
and nerves. The average person spends four hours on their feet and takes between 8,000 and 10,000 steps each day. The feet
are very small relative to the rest of the body, and the impact of every step exerts tremendous force upon them, about 50%
greater than the person's body weight. During an average day the feet support a combined force equivalent to several hundred
tons. In addition to supporting weight, the foot acts as a shock absorber and lever to propel the leg forward, and it serves
to balance and adjust the body to uneven surfaces. It is not surprising, then, that about 75% of Americans experience foot
pain at some point in their lives. According to a recent study, chronic and severe foot pain is a serious burden for one in
seven older disabled women. To compound problems, the lower back is often affected by injuries or abnormalities in the feet.
Foot pain is generally defined by one of three sites of origin: the toes, the front of the foot (forefoot), or back
of the foot (hind foot). Toe problems most often occur because of the pressure imposed by ill-fitting shoes. Pain originating
in the front of the foot usually involves the metatarsal bones (five long bones that extend from the front of the arch to
the bones in the toe) and the sesamoid bones (two small bones imbedded at the top of the first metatarsal bone, which connects
to the big toe). Pain originating in the back of the foot can affect parts of the foot extending from the heel, across the
sole (known as the plantar) to the ball of the foot.
What Causes Foot Pain?
General
Conditions Causing Foot Pain
The causes of most incidents of foot pain are poorly fitting shoes. High-heeled shoes are
major culprits for aggravating, if not causing, problems in the toes, where the most pressure is exerted. Other conditions
can also cause or exacerbate foot pain. Weather affects the feet; they contract in cold and expand in hot weather. Foot size
can also increase by 5% during the day and change shape and size depending on whether a person is walking, sitting, or standing.
Improper walking due to poor posture or inherited or medical conditions that cause imbalance or poor circulation can contribute
to foot pain. Often one leg is shorter than the other, causing an imbalance. 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.
Medical Conditions Causing Foot Pain
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. Osteoporosis, in which bone loss occurs, can also cause foot pain.
Diabetes is a particularly serious cause of foot pain, infection, and ulcers and, without proper foot care, can result in
amputation. Diabetics with foot deformities, such as claw toes or bunions, are at particular risk. Anorexia, high blood pressure,
and other diseases that affect the nervous and circulatory systems 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 pregnancy, high
blood pressure, heart failure, kidney disease, and hypothyroidism, can cause fluid build-up and swollen feet. The increased
weight and imbalance of pregnancy contributes to foot stress. Diseases that affect muscle and motor control, such as Parkinson's
disease, also cause foot problems. Some medications, such as calcitonin and drugs used for high blood pressure, can cause
foot swelling.
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