The Devil Wears Prada: Common Foot Problems in Women

By: Anna Camille Moreno, DO NCMP • ​Georgeanne Botek, DPM • Posted on April 02, 2018 • Updated August 23, 2024

Stylish Shoes Can Be Supportive

There was a book and fashion movie titled “the Devil wears Prada!” Well, we don’t want your shoes to be the devil and we do want you to be able to wear stylish shoes within reason. For walkers, runners and folks with foot problems it is important to wear supportive footwear, which can also be stylish!

Foot problems are very common in women of all ages. Many times foot specialists like your friendly podiatrist recommend surgery on your shoes instead of your feet! Your two feet are very critical to your body’s health and ability to walk and run, but consequently take a lot of beating.

Each foot contains 26 bones, 33 joints and more than 120 muscles, ligaments, tendons, and nerves - and your feet have to support your entire body weight. The important foot functions include:

1. Support the weight of your body
2. Act as shock absorbers
3. Flex and push you forward with each step
4. Help with balance and prevent you from falling

How Common Are Foot Problems?

• 1 in 3 women over the age of 65 has foot pain, aching or foot stiffness.
• In the US, up to 87% of people will have painful feet at some point in their lives. Foot problems worsen with age and the most common complaint in women is pain in the ball of the foot or their heel.
• The most common foot problems are triggered from poor-fitting shoes, including pointy-toed and high-heeled. Many women wear shoes that are too small, too narrow, or high-heeled, with slippery soles and offer no support.
• Foot problems are more prevalent in those who are overweight and have other medical problems including diabetes, heart disease, osteoporosis, and osteoarthritis in other parts of their body.

What are the most common foot problems in women?

Tailor’s Bunion

• Also known as a “bunionette” and is often a hereditary trait commonly seen among family members.
• Described as a bony lump that forms on the outside of the foot, specifically the little toe.
• Can increase in size and could cause skin irritation over the bony lump due to friction from the footwear.

Bunion

• Similar to a Tailor’s Bunion, but always affects the great (big) toe.
• Tight shoes (those that compress the toes) typically rub against this bony protuberance causing other issues such as calluses and skin irritation.
• Bunions are often a hereditary trait commonly seen among family members.

Neuroma

• Refers to thickening of the nerve tissue due to continuous irritation of the nerve from compression.
• Commonly affecting the foot, specifically in between the 3rd and 4th toes called a “Morton’s neuroma”.
• Common symptoms include tingling, burning, and numbness of toes like “there’s something inside the ball of the foot”
• Women who wear tapered toe-box shoes or high heels and those with bunions, hammertoes (crooked toes pointing downward), and flat feet are at increased risk of developing neuromas.

Plantar Fasciitis

• One of the most common causes of foot pain in women.
• Hurts most in the morning when stepping on feet.
• Is treated by plantar foot stretches.
• Do NOT go barefoot as barefoot is for babies only! With age we lose the fat pads or natural cushions on our heels.

Hallux Rigidus

• Is a common type of arthritis of the great toe.
• Can be treated by changing the footwear (avoiding pressure on the joint line).
• You may need an orthotic foot support device.

Arthritis

• One of the most common causes of foot pain in women.
• Degenerative arthritis can cause inflammation, wear and tear of the joints, cartilages, ligaments and tendons that connect to your bones.
• Severe types of arthritis can lead to degeneration of the arch of your foot.
• Osteophytes or bony spurring can cause pressure of the nerves which can cause burning and tingling of your toes and need to be addressed by a foot specialist.

Diabetic Foot

• A complication from underlying, poorly-controlled diabetes.
• Presents as an ulcer, infection, or neuropathy (“pins and needles of the foot”).
• People with diabetes are prone to getting foot ulcers due to their reduced ability to feel pain due to diabetic neuropathy.
• It’s important to wear protective shoes and examine your feet regularly in addition to keeping your blood sugar under control. See a diabetic specialist and a podiatrist specializing in diabetic foot problems. A prescription vitamin Metanx may help.
• Inspect your feet nightly if you have diabetes and do NOT go barefoot ever.

Ingrown Toenail

• Very common and can cause a painful toe infection.
• Occurs when the edges of the nail grow into the skin next to the nail causing redness and swelling.
• Common among those with diabetes and peripheral vascular disease or have circulatory problems or those that have trauma to foot and toenails.
• Soak your feet in Epsom salts and avoid cutting toenails too short.
• See a physician if redness, heat or signs of infection.

Poorly Healing Metatarsal fractures can cause persistent foot pain!

There is a condition called calcific periarthritis and chondrocalcinosis associated with osteomalacia (soft bones) and fractures. People with this condition frequently present to podiatrists with poorly healing metatarsal fractures. Since 2015, asfotase alfa (Strensiq), a recombinant alkaline phosphatase had been approved to treat this condition.

Take-Home Points On Foot Care

1. Wash and moisturize your feet regularly.
2. Avoid tight and ill-fitting shoes, and limit your time wearing fancy high heels. Always pack a pair of comfortable shoes or sneakers to slip into when you are wearing those stilettos and have to walk for a distance.
3. Wear shoes that have supportive arches or wear arch support inserts (orthotics) to support and improve alignment.
4. Shoe modification: wide, low-heeled shoes.
5. Stretching and/or mobilization/manipulation to improve joint mobility and treat or prevent plantar fasciitis.
6. Bunions or callus pads to prevent constant irritation.
7. Ice, use of oral or topical NSAIDs (ibuprofen or aspercreme) or oral Tylenol (acetaminophen) to reduce inflammation with your physician’s approval.
8. Schedule an appointment with your PCP or podiatrist for foot examinations if you have any medical conditions that affect your feet.

Tips for Long Distance Runners and High Endurance Athletes

1. Adequate hydration months prior to your race with application of a softener/hydration like tiger balm.
2. Use a pumice stone to rid your feet of accumulated calluses.
3. Consider getting a professional pedicure about 1 week prior to your race, although note there are some infections risks with manicures and pedicures, so beware.
4. Change your running shoes regularly after so many miles.

You are a woman. Women deserve to look and feel good. Many women love their Jimmy Choos, trademark Christian Louboutins or Prada. Be sensible and seek medical care if your aching feet do not respond to common sense foot care. If you see a physician or podiatrist for a foot problem, be sure to bring in the shoes you wear so they can inspect your footwear.

Be Strong. Be Healthy. Be in Charge!

Dr. Georgeanne Botek and Anna Camille Moreno, DO NCMP

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