Common foot problems in the elderly

Why do older adults develop more foot problems?

The natural ageing process brings the gradual onset of certain health issues, and foot problems tend to be a common issue faced by many older adults. When you spend several decades putting pressure on your feet, they can eventually run into some problems due to a number of age-related factors. For example: 

• Skin on the feet usually loses elasticity, which can make skin issues more common.
• The fat pad on the bottom of the foot starts to thin, which can cause discomfort. This can also lead to an increased risk of foot conditions like plantar fasciitis.
• Joints, ligaments and tendons in the feet may start to degenerate, which can lead to issues like osteoarthritis and cause pain, stiffness and reduced mobility.
• Older adults may be more likely to have a chronic health condition like diabetes, which can affect blood flow and nerve function in the feet. As a result, this can increase the risk of things like foot ulcers and infections.
• Ageing can cause reduced circulation in the extremities, including the feet. This can negatively impact things like wound healing. 
• Many older adults have reduced mobility due to conditions like arthritis, which can cause changes in posture and gait. As a result, foot problems such as bunions and calluses can develop. 
• At any age, wearing improper footwear and neglecting foot and nail health can lead to foot issues, however the likelihood is higher when this has been the case over many years.
• Older adults tend to experience decreased pain sensation in their feet, which means detecting injuries like cuts or infections can be more difficult, leading to delays in treatment.

What are the most common foot problems experienced by older adults?

There are a number of foot problems that cause older adults discomfort in day-to-day life. Some are small, niggling issues, while others are medical issues that require treatment from a GP or podiatrist. Some of the most common foot problems you may come across in older age include: 

Corns and Calluses 

Corns and calluses are hardened, thicker areas of the skin on the foot. Studies have found corns and calluses to be some of the most commonly reported foot conditions in older people, and they can cause foot pain.What causes them? Corns and calluses are often created by continued pressure on an area of the foot, or rubbing of the skin. This might happen when high heels or uncomfortable shoes are worn regularly, or when shoes are worn without socks.What are the signs and symptoms?Corns and calluses may not be visible, or they could look like discoloured or darkened areas of skin. They are usually hard or thick to the touch, and can be painful when they make contact with shoes.What treatments are available? The best way to get rid of corns or calluses on the feet is to wear insoles or apply pads to the affected areas to cushion the contact. You can also soak them in warm water to soften them, use a pumice stone to remove the hard skin, and moisturise. Speak to your GP or a podiatrist about checking and removing corns or calluses, possibly with antibiotics if they become infected. A podiatrist may recommend cutting away the corn or callus, and using special patches or pads to soften hard skin and remove excess pressure from the area. How can I avoid them? To avoid this issue, it can help to start wearing cushioned socks, wide and comfortable shoes, and ensure your footwear always fits well. Also, avoid walking or standing for a long time. 

Foot Pain

There are many reasons an older person may experience foot pain, and it is important to address this as soon as possible so it does not limit mobility. What can cause it? Chronic conditions like diabetes can impact blood flow to the feet and cause nerve damage, which can be a problem in itself, but can also lead to small injuries such as cuts and calluses becoming a much bigger issue down the line. Studies have found those with certain chronic conditions have an increased risk of developing foot pain. What are the signs and symptoms? Aching pain in the foot, or sharp, acute pain at a specific point in the foot. What treatments are available? Treatment will depend on the chronic condition you have, so you should always speak to your GP if you are experiencing any kind of foot pain. In the case of diabetes, this can be dangerous if not treated early as foot issues can lead to ulcers, infections and even amputations in the worst cases. How can I avoid this? Taking care of your feet using some of the tips mentioned at the bottom of this article can help ensure they stay as healthy as possible, but if you have a chronic condition that can affect your feet, it is important to pay attention to any symptoms.It is important to attend a yearly diabetes check which is offered to all UK patients with diabetes. There, a medical professional (normally the long term conditions nurse) will check things like your weight, blood pressure, glucose levels, HbA1c and cholesterol levels, and discuss any symptoms you have been experiencing that could be signs of nerve damage. It is also recommended that you or someone you trust carries out a visual check on your feet every day, such as when you are putting on socks in the morning. This helps to catch any problems early and avoid any issues escalating. 

Nail Disorders 

One study found nail discolouration, thickness and dryness are some of the most commonly reported foot disorders by older people.What causes them? The cause is often conditions like onychomycosis (a fungal nail condition representing around 50% of all nail conditions), onychorrhexis (which causes nails to split and become brittle, flakey or soft), and ingrown toenails (which is when a toenail grows in an irregular way and causes pain or discomfort). What are the signs and symptoms? If your nails start to change over time, becoming discoloured, brittle, thicker, drier, flakey, or easily split, there may be a nail condition causing this. Similarly, if you develop an ingrown toenail which is causing you pain or discomfort, you need to address this. What treatments are available? Depending on the nail condition, your GP or podiatrist can recommend any medications that may be needed to tackle the specific condition you have. If ingrown toenails are the problem, you may need to visit a podiatrist who can properly trim the affected nail, clean it, and apply any necessary bandages until the surrounding skin heals. How can I avoid this? As we age, toenails often become thicker and more brittle, so taking proper care of them on a regular basis is important. Even if you cannot maintain your own nails, you should enlist the help of a loved one or a caregiver to help you manage them. Our Home Instead Care Professionals can help by providing regular visits for nail maintenance at home.  

Toe Deformities 

One study found that one of the most common causes of foot pain is toe deformities, which happen as a result of an imbalance in the muscles within the foot and the leg. They can occur at any age, but are most common in older adults in their 70s and 80s, and women tend to be affected 4-5 times more often than men. What is the cause? Toe deformities are a common foot problem in older people causing an abnormal bend in the joints of one or more toes. This is often caused by wearing narrow shoes for many years. What are the signs and symptoms? Toe deformities can cause stiffness, swelling, pain and discomfort. If you are experiencing any of these symptoms, you should speak to your GP or a podiatrist. What treatments are available? Many toe deformities are permanent, however sometimes surgery is available to realign the joints. While the shape may be permanent, you can aim to alleviate pain and discomfort and restore mobility by stretching, and using toe pads or splints to separate the toes. How can I avoid them? Sometimes toe deformities are unavoidable, but by sticking to properly fitting shoes, avoiding high heels, and never wearing shoes with a narrow toe box, you may be able to ensure your feet remain pain-free. 

Hallux Valgus 

Figures from the Royal College of Surgeons of England found that hallux valgus is present in approximately 28.4% of adults over 40 years old, while another study suggests this is one of the most common foot problems experienced by older adults. What is the cause?Hallux valgus is thought to be caused by multiple contributing factors, such as genetics, abnormal foot mechanics, joint hypermobility, and more. What are the signs and symptoms?Hallux valgus can cause stiffness, pain and/or swelling in the big toe, so if you experience this you may need to seek treatment for this condition. You may also notice your foot becomes wider and you find it difficult to fit into shoes, or you may have difficulty walking. What treatments are available? You can see your GP or podiatrist for advice about treating hallux valgus, such as orthotic devices you can use to reduce bunion pain, and toe spacers or supports to manage discomfort. How can I avoid this? To avoid hallux valgus in future, always wear footwear that fits correctly, ideally that can be adjusted with laces if your foot becomes wider. If you think you have the early signs of a bunion, you can apply pads to keep them from rubbing against your shoes. 

Skin Issues 

Dry skin is a common foot problem experienced by older people, and this can affect the skin of the feet too, particularly the soles of the feet.What causes this? Skin issues are thought to be caused by a gradual decrease in the amount of collagen in the skin as a person ages, which can cause cracks and calluses to form. This can cause foot pain, and could lead to infections if the skin is broken. What are the signs and symptoms? A number of things can happen to the skin that can cause pain or discomfort, such as dryness, flakey patches, irritation, and cracks. Any area of the skin on your feet that shows signs of this should be addressed as soon as possible to avoid further problems. What treatments are available? For certain skin conditions such as psoriasis or eczema, your GP will be able to provide medications that can help, or in cases where the skin is already irritated or broken, they may be able to offer creams to reduce inflammation or reduce your chances of infection. How can I avoid this? The best way to take care of your skin and prevent issues or irritations is to regularly wash and moisturise your feet to keep skin hydrated, soft and supple. This will help to prevent cracking and irritation that can lead to infections.

Osteoarthritis 

Osteoarthritis is a common issue for older adults that is also one of the most common causes of foot problems. Osteoarthritis is thought to affect around 10% of men and 13% of women over age 60, and often the ankle joint and big toe are two of the first areas to be affected.What is the cause?Osteoarthritis is a degenerative condition that affects older adults due to wear and tear of their joints over many years.What are the signs and symptoms? Osteoarthritis tends to be thought of as a condition affecting other areas of the body, such as dexterity in the hands, but it can affect feet too. If you have been noticing joint pain, tenderness, stiffness, restricted movement, weakness or other signs of osteoarthritis, speak to your GP. What treatments are available? Older adults will need to make lifestyle adjustments in order to live with arthritic conditions, however there are some treatment options available to help improve pain, such as medications and surgery.How can I avoid this? There is no particular way to avoid osteoarthritis, but it tends to be more common in women and those with a family history of the condition. Plus, those who have had a past injury to their joint, a pre-existing joint condition, a metabolic disease like diabetes, or obesity, are most at risk of developing this. 

Hammertoe 

Hammertoe is one of the toe deformities mentioned above, but it is worth mentioning separately as it is one of the most common foot problems experienced by older adults. What is the cause? Although it is not clear what causes this to happen, it is believed trauma to the toe, wearing footwear that is tight around the toe area, or an imbalance of the toe muscles could lead to its development. What are the signs and symptoms?Hammertoe is relatively easy to spot as it is an abnormal bend in the toe joint (involving one or more toes). This may also cause corns or calluses in the foot, joint stiffness, swelling, and pain or discomfort.What treatments are available? Without surgery to realign the toes, hammertoe is a permanent condition, however there are some things that can help ease discomfort. Stretching can help to restore joint mobility, and toe pads or splints can address some of the discomfort or pain caused by this condition.How can I avoid this? As ill-fitting shoes are thought to be one of the causes of hammertoe, you may be able to avoid this by always wearing shoes with a wide toe box to give your toes plenty of room to move. 

Circulatory Problems

Circulatory problems regularly affect the feet of older adults, otherwise known as oedema. This means the tissues have swollen, and it can happen in the legs or feet. You can read our guide on this here: Dealing With Swollen Legs In Older Adults.What is the cause? Oedema is caused by poor circulation as fluid builds in the lower limbs, which can be caused by serious conditions like congestive heart failure, chronic kidney disease, venous insufficiency, certain medications, and more. If you are worried you may have any of these issues, speak to your doctor as soon as possible. What are the signs and symptoms?Circulatory problems can be identified in the feet by swelling, sore muscles, a pins-and-needles sensation, pale or blue skin, cold feet, numbness, and bulging veins. If you are worried about symptoms like these, speak to your GP. What treatments are available? There are many medications that can help to treat circulation problems, such as statins and blood thinners, and compression stockings may be recommended by your doctor to help keep blood flowing. In some cases surgery may also be recommended. How can I avoid this? Older adults can improve poor circulation symptoms by getting exercise or moving around, eating a healthy diet, avoiding smoking, maintaining a healthy weight, and managing stress levels. 

Plantar Fasciitis 

A common foot problem found in older adults is plantar fasciitis. This is regularly experienced by people aged 40 to 60, and it is when inflammation affects the band of tissue that runs from the heel to the toes.What is the cause? Often this is caused by general wear and tear in older adults, or atrophy of the heel fat pad. Those who tend to overuse this tissue after long periods of underuse are most likely to be affected. What are the signs and symptoms? The symptoms of plantar fasciitis in older people are the same as in other age groups, and these include things like heel pain, and stiffness or pain in the arch of the foot. One significant feature of plantar fasciitis is that the pain can sometimes be worse when you are taking your first few steps in the morning or after a long period of sitting down. What treatments are available? Seeking treatment for plantar fasciitis from your GP or a podiatrist could mean doing specific stretches, physical therapy, putting ice on the affected area, taking medication, resting the foot, wearing orthotic devices, and wearing shoes with better arch support. In more extreme cases, you may be offered shock wave therapy, as this has been shown to be effective for relieving the pain of this condition. Other treatment options might include steroid injections or surgery. How can I avoid this? To prevent plantar fasciitis, older adults should focus on doing adequate stretches and exercises to keep feet healthy.

How can I look after my feet at home? 

Many of the aforementioned conditions can be avoided with some simple general foot care tips, so it is important as an older individual to develop a regular foot care routine, or engage the help of a loved one or caregiver to assist in making sure your feet are as healthy as they can be. A few things you can start doing from home include: 

• Keep feet clean and dry.
• Apply moisturiser regularly after washing to keep skin soft and supple.
• Avoid wearing old socks to avoid bacteria.
• Be as active as you are able to be, to keep muscles healthy and maintain blood circulation. If you have limited mobility, keep legs raised regularly.
• Look after your toenails with regular trims.
• Watch out for early signs of corns, calluses, skin irritation or other foot problems, and seek treatment early (this is particularly important if you have diabetes). 
• Studies also suggest that avoiding smoking, extreme temperatures on your feet, and going barefoot can also help to maintain good foot health. 

Good footwear is one of the most important things you can do for your feet, so always wear supportive, cushioned shoes that fit well to your foot shape and give your toes the right amount of room. When it comes to which shoes are best, Age UK suggests footwear that reduces your risk of falls and future conditions by being fitted well, with high sides, low heels, thin soles and good grip. 

Should I seek medical attention for foot problems?

The Centres for Disease Prevention and Control suggest that older individuals should have their feet regularly assessed by a medical professional or someone who can check for signs of foot conditions, injuries, skin issues and any other possible problems. You can do this through your GP who can refer you to a foot specialist through the NHS, or reach out to a private podiatrist. If nail care is a problem for you, you can have regular at-home nail care appointments with our experienced, friendly Care Professionals at Home Instead, who can help catch any troublesome nail issues early and help your feet feel refreshed. Those with diabetes should be receiving regular assessments from health professionals to ensure their legs and feet remain in good health. Our Care Professionals can provide a pre-visit risk assessment for conditions like diabetes, haemophilia, poor circulation and more. We will not carry out nail care on diagnosed diabetic patients or those with certain other conditions as they will require specialist foot care from their GP, however in some cases a GP may be able to offer approval for our team to carry out nail care. If appropriate, a Care Professional with an accredited nail cutting and care qualification can attend your home to provide regular checks for signs of ill health, and if necessary, recommendations for clinical intervention.We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the team to discuss your needs.