Published January 13, 2015
Foot pain can mean a lot more than the usual aches from a long walk or standing on the feet all day.
Some foot pains, particularly those that persist for more than a couple of days or even weeks, can be early signs of vascular disease, diabetes or even cancer and should not be overlooked, according to podiatrists.
Dr. Jennifer Fung-Schwartz, podiatrist at the Cabrini Medical Center in New York and spokeswoman for the American Podiatric Medical Association (APMA), said that retailers or other people who may spend all day on their feet at work will usually have foot pain because the muscles may be worn or they may not be getting the right support in their footwear.
But the pain should not be taken for granted and should be checked by a doctor, especially if it persists, because it could be something serious, she said.
Sometimes women in their 30s or 40s will come in and their soles will be swelling, according to Fung-Schwartz, but this could be a normal occurrence during menstruation, so some doctors may disregard it.
But swelling is also usually affiliated with high blood pressure. Osteoporosis can also be found in the feet and legs. In an X-ray, doctors may find the bone density is not as thick as it should be and blackened.
“Usually, when people have foot pain, so many things can cause it,” she said. “In terms of connecting foot pain with a particular disease, it depends on what kind of pain they are having. For example, cramping at night in the leg or feet could mean a problem with the vascular system.”
Vascular problems may make it painful for some to walk due to a blockage that prevents the blood from making it to the muscles. Fung-Schwartz said that if not treated (more potassium in the diet can help), this can lead to amputation because of poor circulation.
“You have to ask the patient when it is happening,” she said. “They will tell you at night ‘my legs will hurt when I’m in bed.’ If they tell you that, there may be segmental pressure, which measures the pressure in lower extremity starting from upper side all the way down.”
Dr. Hillary Brenner of Beth Israel Hospital said that vascular signs usually first show in the feet and then may lead to neurological problems.
“Patients may get a burning or tingling on the tips of their toes,” she said. “You can also feel in the tips of the hands, but the foot is the first place to feel signs.”
Some people who complain of foot pain may have cancer elsewhere in the body. Brenner recently had one patient who was complaining of tendonitis. However, an MRI showed the patient actually had a tumor in the same area of her complaint.
“Most of the time, if you’re standing all day, the muscles in the feet will tell you you need to rest or give them more support,” said Fung-Schwartz. “Once a patient comes in, you have to go through their history. How long has been, happening? Is this ongoing? Have you seen a doctor? There’s so much you have to ask before you come to a conclusion.”
If a patient is complaining of burning or aching in their feet, it could be a sign of type 2 diabetes. Fung-Schwartz added that she usually sees this in people ages 50 to 55, but it’s not limited to any particular age group.
In terms of diabetes, Brenner said that there are other signs in the skin and feet that people should notice.
“Diabetics tend to have thin skin, so they bruise easy,” she said. “If they have a cut, it can take a long time to heal, and it’s just based on the anatomy of the feet. Other signs include the hair on the feet. If they don’t have a lot of hair, or the overall skin color is different, for example, the thinner the skin, you can see a lot of the vessels.”
Brenner said that it’s usually a result of diet and recommends patients visit a nutritionist to learn moderation.
“It’s a progressive thing that happens, it’s not all of a sudden,” she said. “As time goes on, sugars accumulate in blood. Blood feeds nerves, so if there’s a blockage in the blood supply to the nerves, these nerves are not getting the proper nutrition.”
Brenner recommended certain stretching exercises to help general foot pains from getting worse and said that most people have flat foot, which is caused by little or no support in the feet for long periods of time. Flat foot is a main cause of bunions and other problems.
Brenner said that people should not let pain persist for more than two weeks without having a check-up.
Tips for Protecting Your Feet From the American Podiatric Medical Association
1. Don't ignore foot pain. If the pain persists, see a podiatric physician.
2. Inspect your feet regularly. Pay attention to changes in color and temperature of your feet. Look for thick or discolored nails (a sign of developing fungus), and check for cracks or cuts in the skin or peeling or scaling on the soles of feet. Any growth on the foot is not considered normal.
3. Wash your feet regularly, especially between the toes, and be sure to dry them completely.
4. Trim toenails straight across, but not too short. Be careful not to cut nails in corners or on the sides — this can lead to ingrown toenails. Persons with diabetes, poor circulation or heart problems should not treat their own feet because they are more prone to infection.
5. Make sure that your shoes fit properly. Purchase new shoes later in the day when feet tend to be at their largest and replace worn-out shoes as soon as possible.
6. Select and wear the right shoe for more rigorous activity like running.
7. Alternate shoes — don't wear the same pair of shoes every day.
8. Avoid walking barefoot — your feet will be more prone to injury and infection and always use sunblock on your feet just as on the rest of your body.
9. Be cautious when using home remedies for foot ailments — self-treatment can often turn a minor problem into a major one.
10. If you are a person with diabetes, it is vital that you see a podiatric physician at least once a year for a check-up.