Foot Pain

WHEN TO SEE YOUR DOCTOR

* A sore on your foot takes more than one week to heal.

* You also have increasing redness, continual prickling, weakness or a change of sensation in your foot.

* Your feet feel cold or hot all the time.

What Your Symptom Is Telling You

There are lots of medical mysteries. The cure for the common cold. Why doctors always wear those funny white smocks. But the cause of foot pain isn't one of them. In many cases, feet hurt because they've been stuffed into shoes that are of unnatural shape and that don't fit.

Hard to believe? Consider this study of 356 women conducted by the American Orthopedic Foot and Ankle Society: 313 of the women were found to be wearing shoes smaller than their feet. It's not surprising that 285 of the women complained of foot pain. "Narrow, pointed shoes cram the toes and the rest of the foot," says Sally Rudicel, M.D., associate chair of the Department of Orthopaedics at Albert Einstein Medical Center in Philadelphia and chair of the Council on Women's Footwear, which conducted the study. "If you're wearing tight shoes and there's a genetic propensity for a foot problem, you're definitely in trouble."

And trouble can manifest itself in many ways, including bunions and corns, heel spurs ingrown toenails and Morton's neuroma?a shooting pain between the third and fourth toe caused by an inflamed pinched nerve. Morton's neuroma can be confused with bursitis or metatarsalgia?an achy, burning sensation on the ball of the foot.

If you're overweight or on your feet a lot or have a high arch, you may be familiar with plantar fascitis?pain under the heel and arch. Plantar fascitis is caused by overusing the tissue that runs from your heel to the ball of your foot (the fascia). "The forces of walking and running put a lot stress on that area," says Roy Corbin, D.P.M., president of the American Academy of Podiatric Sports Medicine. "Sometimes that leads to calcium deposits and inflammation at the attachment to the heel bone."

Another cause of foot discomfort is a plantar wart?a wart on the bottom of your foot that's caused by a viral infection. Plantar warts are often confused with calluses. But here's what gives them away: small black dots on the top and some mild pain when you squeeze them, according to John Grady, D.P.M., an adjunct clinical professor at the Scholl College of Podiatric Medicine in Chicago and assistant professor of sports medicine at Chicago Osteopathic College. Stress fractures are a common cause of foot pain, especially in walkers, says Dr. Corbin. Suspect stress fractures if there's swelling on the top of the foot right behind the toes.

Other causes of foot pain include an allergic reaction to the dyes or fabrics used in footwear, constricted circulation and a severe case of athlete's foot, says Myles Schneider, D.P.M., an Annandale, Virginia, podiatrist and coauthor of How to Doctor Your Feet without a Doctor.

Symptom Relief

When your feet hurt, you feel lousy all over. Here are a number of ways to banish foot pain.

Shed those shoes. Give your feet a break by going without shoes, or just wearing slippers, whenever you can, says Dr. Corbin. (Keep your shoes on if you have diabetes.)

Elevate your feet. At the end of the day, prop those dogs up, says Dr. Grady. "When you put your feet up for any length of time, fluids leave your feet and you reduce sometimes painful swelling and pressure almost immediately," he says.

Pull the old switcheroo. Switching shoes during the day disperses the pressure throughout your foot. Whenever possible, wear athletic-type shoes and carry your less-comfortable fashion shoes, says Dr. Corbin.

Some dyes and fabrics used in shoes and socks have been known to cause contact dermatitis?a condition with symptoms that can include itching, redness and burning. If you suspect the problem may be caused by something you're wearing, switch shoes and socks for a few days and check the results, says Dr. Schneider.

Go soak. Daily 20-minute foot soaks are fine, if you don't suffer from diabetes. (Soaking may make the skin of your feet drier and, if you have decreased feeling may cause a severe burn if the water is too hot, says Dr. Corbin.) There are a number of commercial foot soaks that you can add. Make sure you moisturize your feet with cream afterward, says Dr. Corbin. Small, store-bought foot basins can also be effective at soothing dog-tired dogs, he says.

Get rubbed. Daily foot rubs with creams containing moisturizers like lanolin can do wonders for folks who spend the day on their feet, says Dr. Corbin. Ask a friend for a five-minute massage or do the job yourself. Either way, you'll love it, he says.

Get shoe smart. When you buy shoes, insist on a good fit. Here, from Dr. Corbin, is what to look for: a deep toe area (about ½ inch of space between your longest toe and the front of the shoe), a firm heel counter (that's the area at the back of the shoe) and a low heel. It's also a good idea to get shoes with laces. Try both shoes on with the same kind of hosiery that you're going to be wearing with the shoes. The widest part of your foot should be at the widest part of the shoe. Do your shoe shopping late in the day. Your feet actually swell in the afternoon, says Dr. Grady.

Think big. If you have Morton's neuroma­type symptoms, try wearing wide shoes or using a metatarsal arch support. (You can buy them by shoe size in drugstores.) For severe and constant pain your doctor may suggest a cortisone injection or, as a last resort, a surgical procedure to release or snip the pinched nerve, Dr. Corbin says.

Healing Heel Pain

If your heel is bothering you, you probably have plantar fascitis or heel spurs. Here's what to do.

Stretch that fascia. Roll a tennis ball or rolling pin under your feet a few times a day when you're sitting down. This soothes and stretches the fascia, making it less likely to become irritated, says Dr. Schneider.

Get some support. Over-the-counter arch supports are an inexpensive way of taking stress off the fascia, says Dr. Corbin.

Get chilled. A paper cup of ice rubbed on the heel for 20 minutes a day is a refreshing way to soothe pain, says Dr. Schneider.

Stretch those calves. Tight calves can cause pain in your Achilles tendon and fascia, says Dr. Rudicel. To avoid it, slowly stretch your calves using this technique: Stand about two feet from a wall and place your hands on the wall at about shoulder height. Step forward with your left leg. While keeping your right knee straight, lean against the wall for a count of 30 and until you feel the stretch in your right calf. Switch legs and repeat.

Pull the Plug on Plantar Warts

Once planted, a single plantar wart could cause a crop to sprout on the feet of your entire family?they're that contagious, says Dr. Corbin. Here's what to do.

Adopt a hands-off policy. Once you have the virus, you can spread a plantar wart to other parts of your feet by picking it, says Dr. Corbin.

Wear flip-flops. Shower shoes can prevent you from giving the virus to someone who's not infected (and from getting it again), says Dr. Corbin.

See your doctor. While several over-the-counter treatments purport to burn off plantar warts, you really need a stronger dose to get the job done. Rather than risk deadening the nerves around the wart with an over-the-counter acid treatment, see your doctor. Some doctors are using lasers to remove warts quickly and easily, says Dr. Grady.

Get into Circulation

If you think your burning feet are caused by poor circulation, here are a couple of ways to get your blood flowing again.

Take a midnight stroll. When the burning sensation occurs at night, instead of counting sheep, take a short walk?around the house if you like. The exercise should put your mind and feet at ease until morning, says Dr. Schneider.

Exercise your feet. Simple exercises, like circling your toes for ten repetitions, can sometimes help get the blood flowing through a burning foot, says Dr. Schneider.