HAPPY FEET

Summer’s most fashionable shoe styles just shout: pick me! But what if you suffer from foot pain? Here’s how to step out without the ouch

Keep your toes and heels in trim!

Are you one of the estimated 1.8 million who has osteoarthritis of the foot or ankle? Then no doubt your top concern is choosing a style of shoe that won’t leave you in agony.

Unfortunately, anyone can suffer from osteoarthritis, a common form of arthritis that results in pain and swelling of the tissues in and around the joints, says Dr Tom Margham, a GP and clinical advisor for Arthritis Research UK. ‘Because our joints are being used continuously, wear is inevitable, but usually the joints repair themselves. However, for some people the natural repair process doesn’t work properly. As a result, the cartilage covering the ends of the bones can roughen and become thin, the bone underneath thickens and the muscles that support the joints become weaker.’

Osteoarthritis can affect any of the 33 joints in the feet, but is most common at the base of the big toe. The pain, stiffness and swelling of osteoarthritis can happen at any time, but often affects those in their late 40s and beyond. ‘Obesity, a joint injury and genetic factors are also known to increase your risk,’ says Dr Margham.

Make a footnote

We all need to pay more attention to our feet, especially as we age. ‘It’s important to look out for pain, stiffness and soft or hard swellings, because early diagnosis and treatment may help ease the symptoms and avoid further joint problems,’ says Dr Gordon Hendry of feetforlife.org.

Less commonly, foot pain may be caused by rheumatoid arthritis, which is caused by the immune system. This commonly affects other joints, too, so foot pain is unlikely to be your only symptom. If diagnosed, you’ll be seen by a rheumatologist and will need medication and annual checks.

There’s no cure for osteoarthritis as yet, but there’s lots you can do to improve symptoms and reduce the chances of the condition getting worse.

n Comfortable, roomy footwear is an absolute must ‘The right shoes can make a real difference, by reducing the stress placed on the feet and joints during everyday activity, as well as lowering the risk of injury and further joint damage,’ says Dr Hendry. ‘For daily wear, the recommendation is to opt for a wide-toed shoe with secure fastenings, a heel height of no more than 2-3cm, plus a firm but flexible sole.’ What about your beloved high heels? ‘There’s increasing evidence that they may trigger degenerative changes in your joints. Wearing sky-high styles all day, every day, can alter your posture and put additional pressure on joints, which can be painful and won’t do you any favours. Save them for short periods or special occasions.’ n Stay active and exercise regularly Keeping joints and muscles strong is key for both prevention and treatment, whatever your age or fitness levels. ‘Osteoarthritis used to be described as wear-and-tear arthritis, but this phrase is out of date. It’s now clear that normal activity doesn’t cause the problem and that exercise won’t make your joints wear out faster,’ says Dr Margham. ‘Yes, doing very hard and intensive activities over and over again – like athletes do – could potentially increase your risk, but when it comes to the strength, flexibility and co-ordination of your feet and ankles, it’s a case of use it or lose it.’ What if it hurts? The natural response is to move less, but this causes you to get weaker, stiffer and lose muscle strength and endurance, which ultimately means more pain in the long term. His advice? ‘Know that you may experience some discomfort when you start out, but “hurt doesn’t always mean harm” – it’s your joints getting used to movement.’ Once you’ve checked with your GP that you’re okay to exercise, start by doing small amounts very slowly, gradually increasing the amount you do. A gentle walk is great, while swimming and cycling are other good options, as they’re low impact. Your GP or a specialist may also give you a programme to follow at home – or visit arthritisresearchuk.org for pain-relieving exercises. n Surgery usually isn’t the answer Non-steroidal anti-inflammatory drugs, special shoe insoles and steroid injections can help. For most people, surgery is only recommended in cases where other treatments have been ineffective. Wondering if glucosamine sulphate tablets might help? ‘There’s no clear scientific evidence they work for most people,’ says Dr Margham. ‘If you want to try them, my advice is to check first with your GP or pharmacist that they’re suitable and then take 1,500mg daily for three months. If your joint pain improves, you can choose to continue with them.’

There’s increasing evidence that high heels may trigger degenerative changes in joints

Shoe shop wisely

◆ Your feet change shape as you get older, especially if you have osteoarthritis, so get measured regularly and look at different sizes, widths and styles. You may also need shoe insoles or inserts. ◆ Vary your heel height throughout the week to keep your foot ligaments supple. ◆ The wider the soles and the more supportive they are, the better. ◆ Try on shoes in the afternoon when feet have had time to swell. Remember that styles and sizes vary greatly from shop to shop. ◆ If you have problem feet, swap your pre-sandal pedi for a podiatrist check-up. To find a registered practitioner, use the ‘find services’ search function at nhs.uk or feetforlife.org. Some people may be able to get podiatry on the NHS or use self-referral – check with your GP surgery.