Once we start to walk, (around the age of one) most of us take around 5000 steps a day, even though the recommended number to maintain health is 10,000. This means that each of our two feet, which are comparatively small compared to our body, carries half our body weight around for at least six hours a day. In addition, the feet have to propel us forward, absorb the shocks and jolts of uneven surfaces and help maintain our balance. The force eventually exerted on the feet is actually 50 per cent greater than the body weight.

The foot has 26 small bones and 33 joints - all to each other by 120 muscles, many ligaments and an intertwining web of nerves. There is therefore a great deal of potential for things to go wrong!

Once the feet start to pain, the function of the whole body is affected. But first, it is important to analyse it. Is it a onetime phenomenon due to an acute injury like hitting a door or stepping on a rock, or is it chronic and long lasting? In either case, it is important to localise the area of the pain broadly into toes, forefoot or hind foot.

Footwear can cause and aggravate foot pain if they are ill-fitting and have hard unyielding soles. Feet (specially those of school children) are often squeezed into shoes a size too small, or may flap around in shoes a size too large. Children's feet do grow rapidly and shoes are expensive but buying the correct size will prevent long lasting damage to their feet. Adults may buy shoes that are in fashion. High heels, pointed toes and shoes too narrow for the feet with hard soles can cause corns and callouses. If feet are squeezed into narrow shoes, the front toes can develop arthritis and pain.

Pain in the feet may be due to the wear and tear of age, or part of a medical problem like rheumatoid or osteoarthritis. Obesity may increase the strain on the foot. The weight gain in pregnancy can cause pain in the feet. Diabetes can make the feet numb and cause nerve damage and shooting pains. Spinal problems, weakness and paralysis, cerebral palsy or Parkinson's disease, all of which cause changes in the gait, can alter the alignment of the joints of the foot and result in pain.

If feet pain, soak them in warm salted water for about 10 minutes. Manipulate the feet with your hands to see if the pain is relieved. Practise proper walking posture. Raise and curl the toes several times. Practise picking up a soft object with the foot. Stand up and rock heel to toe.

If the pain persists, an orthopaedic surgeon needs to be consulted. There may be obvious problems in the forefoot, like hammertoes, claw toes, ingrown toe nails, bunions, corns or callouses. It may be due to a metabolic disorder like gout or diabetes. Specific remedial treatment will cure the pain.

Pain in the midfoot is often due to flat foot. This may have been present from childhood or it may appear with increasing age and obesity. Insoles or corrective footwear will help with this.

The heel often hurts because of the Achilles tendon (the large tendon attaching the calf muscle to the heel pulling on it and causing micro fractures. There may be bursitis under the heel bone, or a bony spur may form there.

Any foot pain that does not disappear in a few days with hot soaks and OTC pain relievers requires a medical evaluation.

 

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in