So Your Feet Ache…

Aching feet is a problem that no one is immune to. Those who work on their feet all day will find it to be an issue, but people in other walks of life are also likely to develop problems with aching feet. The causes of the condition are diverse, but there are some general principles that can help people avoid instances of aching feet as much as possible.

Common Questions to Consider

aching feetSince sore legs and feet can be a consequence of so many different circumstances, it’s important to ask yourself some questions that will clarify the exact nature of your pain. Not only will this help you choose the most appropriate self care options and lifestyle modifications to alleviate the symptoms, it can also help your health care professional to provide the best medical care for you should that become necessary. Not all instances of aching feet will need any sort of medical intervention, but in the event that yours does, it’s best to come prepared with answers to common questions the doctor or nurse may need to ask you.

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Some of the most important issues are:

  • Are you aware of any events or activities which make your pain worse? For example, does standing on your feet for a long time without a break aggravate your symptoms? Does the pain escalate directly after you have gone running, or even in the middle of your run?
  • Where is the pain centered and how far does it tend to spread? Does it feel like a generalized, all over sort of pain, or is it focused in one particular spot on your leg or foot? If it seems to be localized (concentrated) pain, do tendrils of it seem to reach out to the surrounding areas at all?
  • What sort of pain are you experiencing? Does it seem to be a dull throbbing pounding in time to your pulse? Is it a constant dull ache that doesn’t throb at all? Is it more of a sharp, stabbing sensation so fierce that it startles you when it strikes?
  • How long does the pain endure once it begins? Can you rely on a short period of rest to make it fade away, or does it continue to ache no matter what you do? The issue of whether the pain is long term or short term can have important implications for diagnosis and treatment options alike.
  • Is the pain associated with any particular phase of the day, such as getting up first thing in the morning or late at night after a long day of work and chores?
  • When the pain first sets in, does the process feel sudden or gradual to you?
  • Does your level of pain seem to get progressively worse as long as it lasts? Or are there things you know to do that can make it get progressively less fierce and / or shorter in duration?
  • What treatment options have you explored already, and how successful have they been at alleviating the duration or intensity of the pain?

Causes of Aching Feet: Common Problems

aching heelsThere are many different possible causes of aching feet. Some of the most familiar will be standing for long periods of time or exercising a great deal, more than the feet can comfortably tolerate without making some form of objection, usually by responding with pain. A more complete list of common causes would have to include all of the following:

  • Fallen arches (also known as over-pronated feet or “flat” feet)
  • Standing for long periods of time
  • Walking for long periods of time
  • Shoes that do not fit well
  • Shoes that lack sufficient padding
  • Socks or stockings worn too tightly
  • Garters worn too tightly
  • Inadequate blood circulation in the ankles

There are also some causes of aching feet which are more strictly medical in nature. These include:

  • nerve pain caused by an injury
  • Peripheral Nerve Injury
  • Tarsal Tunnel Syndrome
  • Morton’s Neuroma
  • fibromyositis (myofascial pain syndrome)
  • poor circulation
  • restless leg syndrome
  • Shin splint
  • Periostitits
  • Stress fracture

Each of these causes will be explored in detail in the sections relating to symptoms of the various kinds of aching feet syndromes.

Risk Factors for Aching Feet

Apart from the issues implied on the lists above, such as improper footwear or over-exercising the feet and leg muscles, there are other risk factors that can lead to a higher likelihood that a given individual will develop aching feet. Some of these are unfortunately beyond the control of the individual, but some are not. It’s best to be aware of all risk factors in any case. The major risk factors include all of the following:

  • Gender:  Women have a statistical greater chance of experiencing problems with aching feet. Part of this is due to the fact that only women get pregnant, and the increased weight gain acquired during pregnancy can be a factor in foot pain. Pregnancy and childbirth brings with it other issues as well, such as edema, the swelling of feet and ankles due to the accumulation of water in tissues, as well as the onset of pregnancy hormones, some of which can cause ligaments to lose their tension. This is necessary for childbirth to occur without mishap, but in the meantime it can be the cause of injuries to many body parts including the legs and feet. The tendency of women but not men to wear improper footwear, including but not limited to high heels, is another contributing factor to the group’s overall greater likelihood to suffer aching feet.
  • The Aging Process: Many factors of the aging process have implications for good foot health. It is natural for the thick fatty padding on the bottom of our feet to begin to thin out with age. A lifetime of walking and standing contributes to this, and also causes the feet themselves to flatted out into a wider configuration. Many people are aware that as they age their shoe size changes from standard width to wide width, as in the change from size 7 to size 7W. Older men and women also may be beginning to experience degenerative diseases such as adult-onset diabetes, osteoarthritis, and a host of various diseases of the circulatory system. All of these can affect the feet and contribute to aches and pains.
  • Weight: People who are overweight have a much greater likelihood of developing aching feet, particularly as they age.
  • Inadequate water intake: Though many people are not highly aware of it, the feet produce sweat, just as do other parts of the body. Since water is lost through the feet, the tissues making up the feet will be dehydrated and depleted of water quickly unless adequate water is resupplied to them. This is done by drinking sufficient amounts daily. Most experts regard the old adage to drink 8 glasses of 8 ounces each as a bare minimum requirement. People should generally drink more, and overweight people should drink a great deal more.
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Symptoms Associated with Nerve Pain Issues in Aching Feet

Any sort of damage to the nerves in the lower extremities can lead to aching feet. Sometimes, this foot pain may become chronic and last for weeks, months, or even years. One of the oddest aspect of nerve pain is that the patient may feel the injury in a part of the body that did not sustain the damage. This is because nerves are often long structures transmitting pain messages a considerable distance across the body. A patent who has suffered a back injury may be very surprised to find that he or she is experiencing significant pain not in the back, but in the hind portion of the leg. This is a common presentation of injuries to the sciatic nerve, for example.

Common symptoms associated with nerve damage include all of the following:

  • pain is often felt as a sharp, shooting sensation
  • in addition to pain, the patient may experience numbness of the feet
  • there may be a burning or tingling sensation associated with the onset of the pain. At times this may last as long as the pain does.
  • pain may be concentrated in one area or may seem to be spread out over a wider area. This aspect depends on which of the many nerves were involved in sustaining damage.

Nerve pain includes not just generalized or specific damage to a particular nerve, but also several syndromes and conditions such as Morton’s Neuroma, Tarsel Tunnel Syndrome, and Peripheral Nerve Syndrome.

Symptoms Associated with Myofascial Pain Syndrome in Aching Feet

Myofascial Pain Syndrome is more commonly called fibromytosis. Breaking these words down into their Latin roots tells us what the syndrome is all about. Myalgia is a Latin word referring to pain, specifically muscle pain. Myositis, in contrast, refers to the inflammation of soft tissue such as muscle. Myofascial Pain Syndrome, therefore, is a situation in which muscle tissue become inflamed as a result of injury to the soft tissue structures in the area. This includes not only the muscle itself, but also the ligaments and tendons which serve to connect the muscle to other bodily structures and help the muscle do its work.

Myofascial Pain Syndrome can be a result of an underlying condition or an associated condition, but this is not always the case. Sometimes it is strictly the result of a soft tissue injury.

Symptoms associated with Myofascial Pain Syndrome include all of the following:

  • pain that feels aching rather than sharp or shooting
  • stiffness in the muscle tissue
  • tenderness in the muscle tissue
  • pain that specifically occurs in places where tendons connect to the muscles

Symptoms Associated with Poor Circulation to Aching Feet

Poor circulation can be caused by a number of factors. One such factor is the gradual hardening of the arteries over time. As arteries harden (in many cases due to poor diet but also sometimes due to genetic factors and aging), buildup on the interior surfaces of the arteries reduce the flow of blood, sometimes by quite a dramatic degree. At times such arteries can become completely blocked.

Whether arteries are partially or wholly blocked, they will be less effective at doing their primary job, which is to deliver red blood cells carrying oxygen to muscle cells located in muscle tissue. Any decrease in circulation will carry with it the end result of muscles being deprived of the oxygen they need to perform all their functions. The final result of this process is feet and / or legs that feel tired all the time. Muscle tissue so affected can also result in aches and cramps in the affected area.

Chronically aching feet, therefore, may simply be a result of poor circulation in the legs and feet. A medical term for this phenomenon when it results  from hardening of the arteries is “ intermittent claudication.”  The word intermittent indicates that stop and go nature of the problem. Muscles need varying levels of oxygen to function well. Muscles at rest require less fuel than ones that are actively engaged in vigorous physical activity. Therefore, patients with intermittent claudication are more likely to suffer pain in their feet and leg muscles during period of exercise. The exercise itself need not be particularly strenuous – even talking a long distance without taking adequate rest breaks can cause a flare up on cramps and aches. Anything that cause the muscle to work hard or work long will have the same effect.

Aching feet can result from intermittent claudication, but other muscles can also suffer from the condition. These primarily include the thighs, buttocks, hips, and calves. Virtually no part of the leg it immune from this syndrome.

The best short term solution to this problem is to allow the muscle to rest.

Treatment Options for Aching Feet

Most aching foot problems can be taken care of with home care. The most common solutions include:

  • soaking feet in warm water, sometimes infused with soothing oils
  • elevating the feet
  • drinking sufficient water daily
  • orthotic inserts for shoes
  • foot massage
  • foot exercises such as standing on tiptoe and stretching the bottom of your foot by pulling on it with your hands. Another useful exercise is to rotate the foot in all directions – but not while you are standing on it.