Seniors' heel pain can be treated
November 22, 1999
Web posted at: 11:56 AM EST (1656 GMT)
By John A. Cutter
Walking, running, shuffling, marching or trampling -- the typical American does a lot of it. By age 50, most people will have traveled more than 75,000 miles by foot -- and with another possible 40,000 miles to go in years to come, say foot specialists. All that walking takes its toll on aging feet.
It may have to do with poorly fitted, uncomfortable shoes, or it may just be the wear and tear of a lifetime of walking and the normal changes in a foot's structure as people age, doctors say. But whatever the reason, more older people are seeking treatment for heel pain and similar foot problems.
"In the last few years there has been an epidemic of reports of heel pain," says Keith Kashuk, D.P.M., a longtime podiatric foot and ankle surgeon in Miami, Florida, and a member of the American College of Foot and Ankle Surgeons (ACFAS).
"It's a very hot topic," says Kashuk, and one that is poorly understood.
About 14 percent of adult Americans -- or about 31 million people -- complain of heel pain, with millions more suffering in silence because they incorrectly believe that nothing can be done, according to ACFAS.
Symptoms to wrestle with
People with this condition feel pain in their heels when they wake up in the morning or when they start walking after a long period of inactivity, according to ACFAS. Others may feel that the pain subsides during the day but returns in the evening. At its mildest, the pain is an annoyance that causes limping; at its worst, the condition can hurt so much that people become inactive -- which can lead to other health problems.
Many people can try to treat the problem themselves, says Kashuk, who recommends "stretching" the feet daily, especially when waking up and before bed. This stretching can help the fascia, the connective band of tissue that runs from the heel to the toes, which usually is inflamed in people with heel pain.
To exercise the fascia, keep your feet flat on the floor and face a wall. Lean into it as if you are stretching the calf muscle, and hold that position for a few seconds.
Other self-care treatments that doctors recommend for healthy people with heel pain include taking anti-inflammatory drugs such as ibuprofen, and using ice or an ice bath. Avoid vigorous activities such as running: It's important to keep from stressing the feet during recovery.
When buying shoes, choosing comfort over fashion is best, says Kashuk. People should look for shoes -- whether for running, walking or dress occasions -- that fit properly and are comfortable.
If these self-care methods fail, it is best to visit the doctor, because the problem could be more serious. It might be due to bony growths known as heel spurs, or it could be related to arthritis or diabetes. Medicare will cover an initial evaluation from a podiatrist.
Years of use and abuse
Among the many causes of heel pain is simply the wear and tear of years of walking. The foot takes a tremendous amount of pressure with each step -- and when running, that pressure can measure up to three to four times your body weight, according to the American Podiatric Medical Association.
"The tissues of the feet lose some of their elasticity, and the fat pad on the foot's bottom becomes thinner as people age," says Kashuk. This increases the pressure on feet from normal activities like walking, and puts people at higher risk of heel pain from more vigorous exercise or from walking in high heels.
Kashuk says he is participating in a national study that is looking for the causes of heel pain and testing the effectiveness of various treatments.
Some doctors speculate that the trend toward hard tile floors might also be causing more cases of heel pain. Kashuk cautions that the connection has not been established in research studies, but he urges people to wear shoes at home if they have tile floors.
People who suffer heel pain can and do recover, says Joseph Caporusso, D.P.M., a podiatrist in McAllen, Texas, and a member of the American Podiatric Medical Association. He adds that the pain usually subsides within six months in 90 percent of people who receive treatment.
"People sometimes feel that once they pass age 60 their feet should hurt because they are getting older. But foot pain should never be considered normal," says Caporusso. "No one should have to live with foot pain."
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Foot and leg pain
The American College of Foot and Ankle Surgeons
The American Podiatric Medical Association
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