National data reveal that foot and toe symptoms are among the top 20 reasons patients ages 65-74 visit their physician. In the U.S., foot pain is considered a very common musculoskeletal symptom and occurs in such conditions as rheumatoid arthritis, diabetes, and gout, or with sprains, muscle strains, bruises, and fractures. Previous studies have determined a correlation between improper footwear and foot pain, but this research focused on small patient samples or disease specific studies.
Researchers from Boston University School of Public Health and the Institute for Aging Research at Hebrew SeniorLife enrolled 3,372 participants in the Framingham Foot Study. Participants were derived from 2 large population-based samples of residents from Framingham, Massachusetts. The first group was part of the Framingham Study Original Cohort (formed in 1948) and the Framingham Offspring Cohort (formed in 1972) that were originally studied for heart disease risk factors. The second group was a new population sample derived from census data and included subjects who were at least 50 years old and ambulatory who were added to increase participation by minority persons.
The Framingham Foot Study assessed 1,472 men and 1,900 women between 2002 and 2008. Subjects were asked if they experienced pain, aching, or stiffness in either or both feet. Data on specific areas of foot pain was identified in the nails, forefoot, hindfoot, heel, arch of the foot, and ball of the foot. Participants provided information on current and past shoewear across five age groups: 20-29 years, 30-44 years, 45-64 years, 65-74 years, and 75+ years. Shoewear was classified as good (low risk shoes including athletic and casual sneakers), average (mid risk shoes such as hard- or rubber-soled shoes, special shoes and work boots), and poor shoes (high-risk shoewear that lack support and sound structure, including high-heeled shoes, sandals, and slippers).
According to the study 25% of participants reported generalized foot pain on most days with 19% of men and 29% of women falling into this subtype. "In women, we found an increased risk between hindfoot pain and shoewear," said the authors. The study revealed that only a small percentage (< 2%) of men wore poor shoes, thus shoe type is not a major factor for developing foot pain in men. "While more research is needed, young women should make careful choices regarding their shoe type to avoid hindfoot pain later in life, or perform stretching exercises to alleviate the effect of high heels on foot pain," recommended researchers.