Jun 10, 2022
Foot pain is one of the common complaints in our senior citizens amounting to around 35% in individuals aged 65 yrs. or older. It results in poor mobility and the complication bundle it comes with. Hence early identification and proper treatment is a key to getting back our elderly their foot back.
With multiple small bones, the foot provides both flexibility and rigidity through unique biomechanics; it adapts to uneven terrain as a flexible organ, while it also propels the body forward as a rigid lever. Foot pain was significantly associated with increased odds of falling So it needs to be assessed. Women show significantly higher overall foot pain than men. Risk factors include obesity, neurological imbalance osteoarthritis
1. Stress fractures
With ageing, the bone becomes brittle and breaks with even a small amount of deforming force, in the case of the foot even with twisting of the ankle or walking on uneven surfaces. Replacement therapy, regular exercise and individual-based treatment will halo in preventing such types of fractures.
These are the degenerative condition mainly due to repeated usage, seen more commonly in the profession with standing jobs. This wears n tear can be in the ankle or in the toes, resulting in severe pain and limited range of movement in the joints leading to stiffness and more prone to injury and falls. This progressive disease can be tackled with good physiotherapy and exercises. The hip and knee degenerative diseases should be addressed first before attempting any surgery on the ankle and foot.
3. Fat pad atrophy
With ageing and increased BMI, the extra weight and deadly combination of imbalanced walking mechanics can cause the dissolving of fat pads of the foot and can cause pain in the heel and ball of the foot. Fat pad forms thick cushions protecting the bones and nerves. Custom made shoes with insoles will help in the initial stages.
This is because of the accumulation of a by-product called Uric acid, and it may be because of either overproduction or reduced excretion Mainly affecting the great toe but can involve other joints in the form of stiffness and pain with redness and swelling. Dietary modification with the help of a doctor and dietician along with medications will prevent recurrences. Drink a lot of fluids and avoid red meat, shellfish and grams in your diet. A simple blood test will help in diagnosing the blood uric acid levels.
5. Mortons neuroma
Seen in people wearing narrow forefoot footwear, causing compression of nerve causing a sharp shooting type of pain with numbness. A severe pain may need a local injections, a thorough footwear examination and modification will give a lot of symptomatic relief.
6. Ingrowth of toe nail
Due to poor foot care nails can in grow and sweat dead skin cells dust and collected and can get infected, which will couse red swollen painfull toes. Regular foot care might suffice in majority of cases and sometimes might require removal of nail under local anaesthesia.
7. Plantar fasciitis
Heel pain with difficulty in keeping first step out of bed is the most common identifying feature. Rest, ice and stretching exercises with softer footwear are more than sufficient to reduce the pain, it is often confused with other causes of heel pain which requires orthopedician intervention. Hence a consultation is recommended in cases of prolonged heel pain.
8. Tendoachilies tendinitis
This is the irritation of the tendon that helps in pushing off while walking and running and also plays a major role in climbing stairs. Smokers with peripheral vascular insufficiency can also lead to chronic rupture. With the loss in power, there can be a pain in the back of the heal. While tendinitis can be treated with medicines and physiotherapy intervention, tears require surgical intervention.
9. Diabetic foot
Diabetes causes a lack of sensation in the foot which results in micro trauma going unnoticed and along with delayed wound healing and superadded infection, it will lead to non-healing diabetic foot ulcers and also Charcot arthropathy leading to deformed foot biomechanics. which have a good outcome with early intervention.
In the Elderly foot, disorders are common and cause significant morbidity and functional limitation in being independent and also increase the risk of falls. Identification of the issue can be made with diligent foot care and in case of long-term issue with a consultation of Orthopaedic and by clinical evaluation and imaging studies including plain radiographs and ultrasound. Most people improve with nonoperative methods like function-oriented rehabilitation programs and therapeutic exercise, the use of proper footwear and selected small operative interventions as indicated.