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:

Neuromas
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 damage.

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. 

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