In Brief:

Huge numbers of people develop foot pain in their 60s, but it can start as early as the 20s and 30s.

Excessive weight, diabetes and circulation problems can contribute to foot pain.

Proper footwear and regular exercise can play a crucial role in preventing foot problems.

The average person walks the equivalent of three times around the Earth in a lifetime. That is enormous wear and tear on the 26 bones, 33 joints and more than 100 tendons, ligaments and muscles that make up the foot.

In a recent survey for the American Podiatric Medical Association, 53 percent of respondents reported foot pain so severe that it hampered their daily function. On average, people develop pain in their 60s, but it can start as early as the 20s and 30s. Yet, except for women who get regular pedicures, most people don’t take much care of their feet.

“A lot of people think foot pain is part of the aging process and accept it, and function and walk with pain,” said Dr. Andrew Shapiro, a podiatrist in Valley Stream, N.Y. Though some foot problems are inevitable, their progress can be slowed.

The most common foot conditions that occur with age are arthritic joints, thinning of the fat pads cushioning the soles, plantar fasciitis (inflammation of the fibrous tissue along the sole), bunions (enlargement of the joint at the base of the big toe), poor circulation and fungal nails. The following questions will help you assess whether you should take more preventive action as you age.

Are you overweight? The force on your feet is about 120 percent of your weight. “Obesity puts a great amount of stress on all the supporting structures of the foot,” said Dr. Bart Gastwirth, a podiatrist at the University of Chicago. It can lead to plantar fasciitis and heel pain and can worsen hammertoes and bunions. It’s also a risk factor for diabetes, leading to the next question.

Are you diabetic? Being farthest from the heart, the feet can be the first part of the body to manifest complications like poor circulation and loss of feeling, both of which can lead to poor wound healing and amputation. Diabetics should have their feet examined annually by a doctor and avoid shoes that cause abrasions and pressure.

Do you have poor circulation? If you suffer from peripheral artery disease — a narrowing of veins in the legs — your feet are more susceptible to problems, said Dr. Ross E. Taubman, president of the American Podiatric Medical Association. Smoking also contributes to poor circulation.

Do your parents complain about their feet? Family history is probably your biggest clue to potential problems.

Do you have flat feet or high arches? Either puts feet at risk. A flat foot is squishy, causing muscles and tendons to stretch and weaken, leading to tendinitis and arthritis. A high arch is rigid and has little shock absorption, putting more pressure on the ball and heel of the foot, as well as on the knees, hips and back. Shoes or orthotics that support the arch and heel can help flat feet. People with high arches should look for roomy shoes and softer padding to absorb the shock. Isometric exercises also strengthen muscles supporting the foot.

Are you double-jointed? If you can bend back your thumb to touch your lower arm, the ligaments in your feet are probably stretchy, too, Dr. Gastwirth said. That makes the muscles supporting the foot work harder and can lead to injuries. Wear supportive shoes.

Do your shoes fit? In the podiatric association’s survey, more than 34 percent of men said they could not remember the last time their feet were measured. Twenty percent of women said that once a week they wore shoes that hurt, and 8 percent wore painful shoes daily. Feet flatten and lengthen with age, so if you are clinging to the shoe size you wore at age 21, get your feet measured (especially mothers — pregnancy expands feet).

Do you wear high heels? “The high heel concentrates the force on the heel and the forefoot,” Dr. Gastwirth said. Heels contribute to hammertoes, neuromas (pinched nerves near the ball of the foot), bunions and “pump bump” (a painful bump on the back of the heel), as well as toenail problems. Most of the time, wear heels that are less than two and a half inches high.

Do your feet ever see the light of day? Fungus thrives in a warm, moist environment. Choose moisture-wicking socks (not cotton), use antifungal powders and air out your toes at home.

Have you seen a podiatrist? Minor adjustments, using drugstore foot pads or preion orthotics, can relieve the pressure on sensitive areas, rebalance the foot and slow the progress of a condition.

Do you walk? Putting more mileage on your feet is the best way to exercise the muscles and keep them healthy.

Publish date: 6/19/2008