Foot Health for Women
Women are more vulnerable to certain foot problems than men, mainly from
years of walking in narrow-fitting shoes that squeeze the toes and from
high heels that cramp the forefoot and pose risks for arch and ankle problems. Some common foot problems for women are:
A neuroma is a thickening of nerve tissue. In
the foot, it most commonly occurs at the base of the third and fourth toes. This
condition is called Morton’s neuroma or intermetatarsal neuroma. Neuromas may
also occur in other locations in the foot and are caused by compression and
irritation of the nerve, producing swelling and possible permanent nerve
A major risk factor is wearing shoes with a tight toe box, or high-heeled
shoes that force the foot into the toe box. Women who run, play racquet sports
or participate in physical activities that exert repetitive stress on the
forefoot are prone to develop neuromas. The combination of repetitive stress
activities and wearing tight fitting shoes increases the risk for women.
Neuromas enlarge as the condition progresses, causing tingling, burning pain
and numbness of the toes. Patients often complain it feels as if something is
stuck inside the ball of the foot. The symptoms may go away temporarily by
massaging the foot, wearing wider shoes with low heels, and avoiding activities
that exert stress on the forefoot. Symptoms become more intense as the nerve
enlarges and the temporary damage becomes permanent. Therefore, it’s best to
seek treatment if discomfort persists for more than a few days. A neuroma isn’t
detectable by x-ray, so the diagnosis is based on symptoms and a physical
examination during which a physician attempts to reproduce the symptoms by
manipulating the foot.
Treatment options depend on severity. At early stages, padding lessens
pressure on the nerve, icing reduces swelling, non-steroidal anti-inflammatory
drugs, such as ibuprofen, decrease pain and inflammation, and custom orthotic
devices provide support to reduce compression. Also, physical activity
modifications might be recommended as well as avoiding narrow, tight fitting
shoes and high heels.
In severe cases, surgery might be the best option to provide relief. A foot
and ankle surgeon can release or remove the affected nerve in an outpatient
procedure. Surgery for neuromas has a very high success rate. It relieves the
pain, although there might be a loss of sensation in the area where the nerve
provides feeling to the toe.
Heel Pain (Plantar Fasciitis)
Heel pain is most often
caused by plantar fasciitis, a condition that sometimes is also called heel spur
syndrome when a spur is present. Heel pain may also be due to other causes, such
as a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely, a
tumor. Because there are several potential causes, it is important to have heel
pain properly diagnosed to consider all the possibilities and determine the
underlying source of heel pain.
Adult foot complaints diagnosed as plantar fasciitis, result from chronic inflammation of the connective tissue extending from the heel to the toes.
Although faulty foot structure is the most common cause of plantar fasciitis,
being overweight and wearing non-supportive shoes are common contributing
factors. Heel pain is most noticeable after getting out of bed in the morning,
but it tends to decrease after a few minutes and returns during the day after
sitting for long periods of time.
Self-treatment of heel pain, such as taking non-steroidal anti-inflammatory
drugs and doing stretching exercises, often is tried before seeking medical
advice. To help diagnose its origin, physicians will ask about the time of day
the heel pain occurs, types of shoes worn regularly, normal physical activities,
and if recent trauma has occurred. X-rays, MRIs or bone scans can help
differentiate various types of heel pain.