Prevalence of foot pain in the population

NewsBot · Apr 13, 2010

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High prevalence of foot problems in the Danish population: A survey of causes and associations.
Mølgaard C, Lundbye-Christensen S, Simonsen O.
Foot (Edinb). 2010 Apr 9. [Epub ahead of print]

OBJECTIVE: To determine the prevalence and severity of foot pain and deformity and the associated risk of leg and low back pain.

METHOD: A cross-sectional postal survey was conducted among a randomly selected sample of 2100 adult Danish inhabitants (18-80 years of age). Participants reported 1-month period prevalences of foot, lower leg, knee, hip and back pain.

RESULTS: Responder rate was 79.6%. Prevalence of foot pain was 30.4% with a total of 55.9% reporting pain in the foot, leg or back lasting more than 1 day within the previous month. Foot pain lasting more than 1 month was experienced by 16.2% and 11.9% had pain lasting more than 1 year. The prevalence of self-reported pes planus or pes cavus was 17.9%. There was a significant association between foot pain and pain elsewhere in the leg and low back. Self-reported foot deformity was significantly associated with foot pain. Women had a significantly higher prevalence of foot pain and Body Mass Index was associated with foot pain in women but not in men.

CONCLUSIONS: Foot pain is highly prevalent and associated with foot deformity and leg and low back pain. More attention should be focused on foot pain and foot deformity. It is suggested that clinical examination of leg and low back pain should include foot examination.
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NewsBot · Sep 28, 2010

Prevalence of hallux valgus in the general population: a systematic review and meta-analysis
Sheree Nix, Michelle Smith and Bill Vicenzino
Journal of Foot and Ankle Research 2010, 3:21doi:10.1186/1757-1146-3-21

Background
Hallux valgus (HV) is a foot deformity commonly seen in medical practice, often accompanied by significant functional disability and foot pain. Despite frequent mention in a diverse body of literature, a precise estimate of the prevalence of HV is difficult to ascertain. The purpose of this systematic review was to investigate prevalence of HV in the overall population and evaluate the influence of age and gender.

Methods
Electronic databases (Medline, Embase, and CINAHL) and reference lists of included papers were searched to June 2009 for papers on HV prevalence without language restriction. MeSH terms and keywords were used relating to HV or bunions, prevalence and various synonyms. Included studies were surveys reporting original data for prevalence of HV or bunions in healthy populations of any age group. Surveys reporting prevalence data grouped with other foot deformities and in specific disease groups (eg. rheumatoid arthritis, diabetes) were excluded. Two independent investigators quality rated all included papers on the Epidemiological Appraisal Instrument. Data on raw prevalence, population studied and methodology were extracted. Prevalence proportions and the standard error were calculated, and meta-analysis was performed using a random effects model.

Results
A total of 78 papers reporting results of 76 surveys (total 496,957 participants) were included and grouped by study population for meta-analysis. Pooled prevalence estimates for HV were 23% in adults aged 18-65 years (CI: 16.3 to 29.6) and 35.7% in elderly people aged over 65 years (CI: 29.5 to 42.0). Prevalence increased with age and was higher in females [30% (CI: 22 to 38)] compared to males [13% (CI: 9 to 17)]. Potential sources of bias were sampling method, study quality and method of HV diagnosis.

Conclusions
Notwithstanding the wide variation in estimates, it is evident that HV is prevalent; more so in females and with increasing age. Methodological quality issues need to be addressed in interpreting reports in the literature and in future research.
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NewsBot · Oct 25, 2011

The population prevalence of foot and ankle pain in middle and old age: A systematic review.
Thomas MJ, Roddy E, Zhang W, Menz HB, Hannan MT, Peat GM.
Pain. 2011 Oct 19. [Epub ahead of print]

A systematic review and meta-analysis of population-based epidemiological studies was undertaken to determine the prevalence of foot and ankle pain in middle and old age. Searches were conducted in the following electronic databases from inception to October 2010: PubMed, EMBASE, AMED, CINAHL, Cochrane, PEDro, and SportDiscus. Full-text English language articles were included if they used population sample frames, cross-sectional design or analysis, and reported prevalence estimates for foot and/or ankle pain in adults aged 45years and over. Thirty-four articles from 31 studies involving 75,505 participants provided 529 prevalence estimates based on different case definitions and population strata. Random-effects meta-analyses of studies with comparable case definitions provided pooled prevalence estimates, for frequent foot pain of 24% (95% confidence interval 22-25%; n=3; I(2)=46%) and for frequent ankle pain of 15% (95% confidence interval 13-16%; n=2; I(2)=0). Small sample sizes and low response rates in some studies, together with heterogeneous case definitions, limit confident conclusions on the distribution, subtypes, and impact of foot/ankle pain. Narrative synthesis of evidence from existing studies suggested preponderance in females, an age-related increase in prevalence in women but not men, that the toes/forefoot were the most common anatomical sites of pain, and that moderate disability in an aspect of daily life was reported by two-thirds of cases. This review provides estimates of the community burden of foot and ankle pain in middle and old age. By outlining the scale of this clinical problem, these findings can be used to inform health care planning and provision.
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NewsBot · Nov 29, 2013

Prevalence of nontraumatic foot pain among urban young working women and its contributing factors.
Chua YP, Tan WJ, Ahmad TS, Saw A.
Singapore Med J. 2013 Nov;54(11):630-3.

INTRODUCTION:
Foot pain is a common problem, especially in women, and studies have shown that it is related to footwear. This study was conducted to establish the prevalence of nontraumatic foot pain and its contributing factors in young working Malaysian women in an urban setting.
METHODS:
The survey was conducted on a group of working women (age range 21-40 years) selected using convenience sampling. Data on foot problems was collected through an investigator-directed questionnaire and during clinical inspection of the foot.
RESULTS:
A total of 400 women, with a mean age of 29.4 years, were recruited. Half (n = 200) of the women had experienced recurrent nontraumatic foot pain in the past one year. Subjective assessments of foot pain using the Numeric Intensity Scale gave an average score of 4.89 ± 1.78 (range 2-10), with most episodes occurring at the heel. There was no statistically significant association between foot pain and age, ethnicity or body mass index. However, there was a higher incidence of foot pain in women wearing high-heeled footwear than those wearing non-high-heeled footwear (p = 0.027, odds ratio 1.591).
CONCLUSION:
Nontraumatic foot pain is common among young working women in our society. More than half (68.4%) of the women with foot pain in our study attributed the pain to footwear. Wearing high-heeled shoes to work was a significant contributing factor. Increased public awareness on the importance of proper footwear may help to reduce the prevalence of nontraumatic foot pain in working women.
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NewsBot · Sep 10, 2014

Foot problems among elderly people in Hong Kong
TL Lai, KL Chan, SL Chung
Asian Journal of Gerontology & Geriatrics Online First

Objective.
To evaluate the prevalence and pattern of foot problems,
and mobility among 85 elderly people in Hong Kong.
Design.
Cross-sectional survey
Main outcome measures.
Characteristics of the subjects, foot problems
and patterns, and mobility.
Results.
65 women and 20 men (mean age, 79 years) from 3 community
centres in Kowloon District were invited for foot screening. 81% of
subjects had at least one foot problem; the most common was callus
(45%), followed by hallux deformity (37%), dystrophic nail (27%), and
nail onychomycosis (24%). 45% of subjects had foot pain, and 61%
of subjects were aware of their foot problems. Only 28% of subjects
sought medical consultation, and 41% of subjects did not have well-
fitting footwear. 99% of subjects were ambulatory; the median (range)
Elderly Mobility Scale score was 17 (15-17) out of 20.
Conclusion.
Foot problems were common in our elderly population,
but the rate of medical consultation was low. Most elders did not have
well-fitting shoes. Education on preventive podiatry medicine and
routine foot examination is necessary to promote better foot health.
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NewsBot · Dec 17, 2014

Podiatric Medical Abnormalities in a Random Population Sample 40 Years or Older in Spain.
Salvador Pita-Fernandez, Cristina González-Martín, Teresa Seoane-Pillado, Sonia Pertega-Diaz, Sergio Perez-Garcia, and Beatriz López-Calviño
Journal of the American Podiatric Medical Association: November 2014, Vol. 104, No. 6, pp. 574-582.

Background: Podiatric medical abnormalities are highly prevalent, yet few random population studies exist that determine the presence of pathologic abnormalities in the feet, despite their importance. The aim of this study was to determine the prevalence of podiatric medical abnormalities in a random sample population 40 years or older.

Methods: An observational study was conducted of a random sample population (n = 1,002) located in A Coruña, Spain. Anthropometric variables, comorbidity (Charlson score), quality of life (36-item Short-Form Health Survey), and podiatric medical examination findings were studied. A descriptive analysis and multivariate logistic regression were performed.

Results: The most common diseases were claw toes (69.7%), hallux valgus (38%), and hallux extensus (15.8%), which increased with age and female sex. The most frequent metatarsal formula was index minus (40.9%), followed by index plus minus (35.0%). The most frequent digital formula was Egyptian foot (57.1%), followed by Greek foot (31.4%). In this study, although the presence of podiatric medical abnormalities reduced the probability of enjoying a better quality of life, it did not do so significantly. After taking into account age, sex, comorbidity, body mass index (BMI), and the presence of podiatric medical abnormalities, the variables with an independent effect that modified the physical component of quality of life were sex (female), comorbidity, and BMI.

Conclusions: There was a high prevalence of podiatric medical abnormalities, which increased with age and female sex. Comorbidity, BMI, and sex modified quality of life independently of podiatric medical abnormalities.
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NewsBot · Feb 1, 2015

Foot and Ankle Problems in Thai Monks
Tanawat Vaseenon, Thongaek Wattanarojanaporn, Piyapong Intharasompan, Nipon Theeraamphon, Sansanee Auephanviriyakul, Phinit Phisitkul
JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND, Vol 98, No 1

Background: Foot and ankle problems in Thai monks have not been explored. This is an unshod population, and its members have a unique lifestyle living among others in our modern era. Beginning at their ordainment, they follow strict rules about barefoot walking, the amount of daily walking, and their sitting position, practices that theoretically can increase their risk of developing foot and ankle problems.
Objective: To evaluate the prevalence of common foot and ankle problems in Thai monks.

Material and Method: A cross-sectional survey was conducted in combination with foot and ankle examinations of monks living in northern Thailand. Foot morphology was examined using a Harris mat footprint. Results of the interviews and the foot and ankle examinations were evaluated.

Results: Two hundred and nine monks from 28 temples were included in this study. Common foot and ankle problems found included callosity (70.8%), toe deformities (18.2%), plantar fasciitis (13.4%), metatarsalgia (3.8%), and numbness (2.9%). Callosity and toe deformities were associated with prolonged barefoot walking over extended periods since ordainment (p<0.05). The callosity was found on the forefoot (47.3%), lateral malleolus (40.7%), and heel (12%). Arch types were considered normal in 66.4% of cases, high in 21.6%, and low in 12%. No association was found between arch type and foot and ankle problems.

Conclusion: Callosity and toe deformity were the most common foot and ankle problems found in Thai monks, especially those with prolonged period of barefoot walking and long-term duration of ordainment. The unique pattern of walking and sitting of Thai monks may have contributed to the development of those feet and ankle problems
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NewsBot · Feb 14, 2015

The prevalence of musculoskeletal pain & its associated factors among female Saudi school teachers.
Abdulmonem A, Hanan A, Elaf A, Haneen T, Jenan A.
Pak J Med Sci. 2014 Nov-Dec;30(6):1191-6. doi: 10.12669/pjms.306.5778.

OBJECTIVES:
To quantify the prevalence and identify the associated factors of musculoskeletal pain among Saudi female school teachers.
METHODS:
An observational quantitative cross-sectional survey of female Saudi school teachers in five different areas of Saudi Arabia was carried out between August and October 2013. A self-administered questionnaire was used in which the items related to participants' demographic information and pain information were included. A numeric pain rating scale was used for patient self-reporting of pain. Data analysis was carried out using SPSS Pc+ version 21.0 statistical software.
RESULTS:
Four hundred and eighty six female school teachers responded to the survey. Severe Low back pain was reported by 38.1% of teacher, followed by knee pain (26.3%), heel (24.1%), shoulder (20.6%), upper back (17.7%), hip joint (16.5%),ankle (12.3%), neck (11.3%). Sever pain of elbow (5.6%) and wrist (7.4%) was the least reported. Pain affected work at school in 46.1% of school teachers. A combination of variables: body mass index, Vitamin D deficiency, teaching level, presence of chronic illness, were found to be significantly associated with musculoskeletal pain.
CONCLUSION:
The results of self-reported prevalence of musculoskeletal pain among female Saudi school teachers is useful to educate the school teachers for adequate care so as to prevent these pains. There is a need for the higher authorities to address this issue and implement intervention programs to alleviate the pain and suffering of these school teachers.
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NewsBot · Feb 14, 2015

Foot ailments during Hajj: A short report
Shruti Sridhara et al
Journal of Epidemiology and Global Health; Available online 7 February 2015

A study of ailments of the feet in pilgrims of Hajj revealed that 31% of them suffered from blisters, and the prevalence was five times higher in females. The presence of comorbidity (diabetes, obesity and advanced age) warrants immediate attention to them to avoid serious complications.
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NewsBot · Oct 6, 2015

Dermatologic Foot Complaints of the Young Adults: A Prospective Study from a Dermatology
Outpatient Clinic in Turkey
Gen? Erişkinlerde Ayağın Dermatolojik Problemleri: T?rkiye’de Bir Dermatoloji Polikliğinde Yapılan Prospektif ?alışma
GMJ; 2015; 26: 174-176

Objective: Young adulthood can be considered the healthiest time of life and
young adults are generally in good health. However many adult patients
presented to hospitals for various problems including dermatologic
complaints. Almost 70 % of adults have various foot problems. Although there
are more detailed population based surveys where participitants self-reported
problems of foot and toenail pathology, there is sparse data about the
dermatological foot problems of the young adults. The aim of this study is to
determine the dermatologic foot complaints of the young adults attending a
dermatology outpatient clinic.
Type of the study: Prospective study
Methods: Patients aged between 18 and 35 years, who were admitted to the
dermatology outpatient clinic with a complaint of dermatologic foot disorders
over a 6-months period were included. Demographic features of the patients
were recorded. The patients were asked for the dermatologic complaints of
the feet.
Results: A total of 107 young adult patients attended the dermatology
outpatient clinic with a complaint of dermatologic foot problems over a 6-
months-period. Overall, the five most frequent dermatologic foot complaints
were tinea pedis (20.5 %), verruca (16.8 %), callosities (15.8 %), unguium
incarnatus (13.1 %), and onychomycosis (9.3 %). In males; the most frequent
complaint was tinea pedis (27.2 %), followed by verruca (18.1 %) and
onychomycosis (12.7 %) whereas in females; the most frequent complaint was
callosities (23.1 %), followed by unguium incarnatus (17.3 %), and verruca
(15.3 %).
Conclusions: Most of the dermatologic complaints of the foot in young adults
are preventable and treatable. Medical education programs for health care
personnal and young adult population would have a great contribution in
informing the people about the preventive measures and the proper
treatments of dermatologic foot problems.
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NewsBot · Nov 26, 2015

Prevalence of foot disease and risk factors in general inpatient populations: a systematic review and meta-analysis.
Lazzarini PA et al
BMJ Open. 2015 Nov 23;5(11):e008544. doi: 10.1136/bmjopen-2015-008544.

OBJECTIVE:
To systematically review studies reporting the prevalence in general adult inpatient populations of foot disease disorders (foot wounds, foot infections, collective 'foot disease') and risk factors (peripheral arterial disease (PAD), peripheral neuropathy (PN), foot deformity).
METHODS:
A systematic review of studies published between 1980 and 2013 was undertaken using electronic databases (MEDLINE, EMBASE and CINAHL). Keywords and synonyms relating to prevalence, inpatients, foot disease disorders and risk factors were used. Studies reporting foot disease or risk factor prevalence data in general inpatient populations were included. Included study's reference lists and citations were searched and experts consulted to identify additional relevant studies. 2 authors, blinded to each other, assessed the methodological quality of included studies. Applicable data were extracted by 1 author and checked by a second author. Prevalence proportions and SEs were calculated for all included studies. Pooled prevalence estimates were calculated using random-effects models where 3 eligible studies were available.
RESULTS:
Of the 4972 studies initially identified, 78 studies reporting 84 different cohorts (total 60 231 517 participants) were included. Foot disease prevalence included: foot wounds 0.01-13.5% (70 cohorts), foot infections 0.05-6.4% (7 cohorts), collective foot disease 0.2-11.9% (12 cohorts). Risk factor prevalence included: PAD 0.01-36.0% (10 cohorts), PN 0.003-2.8% (6 cohorts), foot deformity was not reported. Pooled prevalence estimates were only able to be calculated for pressure ulcer-related foot wounds 4.6% (95% CI 3.7% to 5.4%)), diabetes-related foot wounds 2.4% (1.5% to 3.4%), diabetes-related foot infections 3.4% (0.2% to 6.5%), diabetes-related foot disease 4.7% (0.3% to 9.2%). Heterogeneity was high in all pooled estimates (I(2)=94.2-97.8%, p<0.001).
CONCLUSIONS:
This review found high heterogeneity, yet suggests foot disease was present in 1 in every 20 inpatients and a major risk factor in 1 in 3 inpatients. These findings are likely an underestimate and more robust studies are required to provide more precise estimates.
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NewsBot · Feb 23, 2018

Prevalence estimation and familial tendency of common forefoot deformities in Turkey: A survey of 2662 adults
Uğur Şaylı et al
Acta Orthopaedica et Traumatologica Turcica; 19 February 2018

Objective
This survey was designed to evaluate the prevalence estimations of HV, bunionette, hammertoe as well as their relations to shoe wearing and also familial tendency, in Turkey.

Material and Methods
Two thousand six hundred sixty two volunteers (1615 females and 1047 males) with a mean age of 34.15 ± 14.23 (range; 18 to 96) years were asked to answer the predetermined questionnaire between January and June, 2016. Hallux valgus, hammertoe and bunionette images were provided as references and every adult participant without any known forefoot problems or past forefoot surgery history was asked to rate his/her foot and to respond the questions about family history and shoe wearing habits. Responses were statistically analyzed.

Results
The prevalence estimations of hallux valgus, bunionette and hammertoe were calculated as 54.3%, 13.8% and 8.9% and positive family history rates were 53.2%, 61.2% and 56.1%, respectively. All three deformities were more common in females than in males (p < 0.001). Nonetheless the older age group reported significantly higher prevalence rates for only HV (p < 0.001). Likewise, among the three deformities, females reported a higher rate of positive family history only in HV compared to men (p < 0.001). Constricting shoe wear was found to affect HV incidence in women (p < 0.001) and bunionette incidence in both sexes (p < 0.01).

Conclusion
This study concludes that forefoot deformities are common with high familial tendency. Hence it is worthwhile to work on molecular genetics and this may enable the anticipation of forthcoming deformities in order to take early action in prevention, in nearly the half of the population.
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NewsBot · Apr 4, 2018

Foot health and quality of life among university students: cross-sectional study
David Rodríguez-SanzI et al
Sao Paulo Med. J., ahead of print Epub Mar 29, 2018

BACKGROUND:
Foot problems are believed to reduce quality of life and are increasingly present. Even among young adults of university age, untreated foot problems can lead to postural and mobility problems. Accordingly, our aim here was to determine the relationship between foot health and quality of life and general health among male and female university students.

DESIGN AND SETTING:
Observational cross-sectional quantitative study conducted at the Podiatric Medicine and Surgery Clinic of the University of Coruña, Ferrol, Spain.

METHODS:
A sample of 112 participants of median age 22 years came to a health center, where self-reported data were registered, including professional activity, and scores obtained through the Foot Health Status Questionnaire (FHSQ) were compared.

RESULTS:
In Section One of the FHSQ, the university students recorded lower scores of 66.66 in the footwear domain and 60 in the general foot health domain and higher scores of 84.37 in the foot pain domain and 93.75 in the foot function domain. In Section Two, they obtained lower scores of 60 in the overall health domain and 62.50 in the vigor domain and higher scores of 100 in the physical activity and 87.50 in the social capacity domain. Differences between males and females were evaluated using the Wilcoxon rank-sum test, which showing statistical significance (P < 0.05) regarding the dimensions of footwear and general foot health.

CONCLUSIONS:
These university students’ quality of life relating to foot health was poor. This appears to be associated with the university period, regardless of gender.
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NewsBot · Aug 15, 2018

Changes to the feet of institutionalized elderly persons
Eidimara Ferreira et al
Rev. bras. geriatr. gerontol. vol.21 no.3 Rio de Janeiro May/June 2018

Objective:
The present study aimed to identify the most frequent changes to the feet of institutionalized elderly persons.

Method:
A descriptive study was conducted with elderly persons living in long-term care facilities in the city of Passo Fundo, Rio Grande do Sul, Brazil. A total of 174 people aged 60 years and over of both genders were surveyed regardless of health conditions. Those with amputations, burns or who were undergoing surgery of the lower limbs were excluded. Data were collected through the application of a structured questionnaire containing sociodemographic variables (age, gender, ethnicity, marital status, schooling, main occupation) and variables related to alterations of the feet (nail, dermatological and bone deformities). The Manchester Scale was subsequently applied to evaluate the degree of hallux deformity.

Results:
The most frequent nail deformities were onychomycosis, onychogryphosis, onycholysis, onychosclerosis; the dermatological findings were callosities, especially interdigital and bromhidrosis; the most prevalent bone deformities were pes cavus and transverse arches. In the assessment of hallux valgus, according to the Manchester Scale, painful feet (38.5%), mild deformities (35.6%) and no deformities (25.3%) were identified.

Conclusion:
The results suggest signs of neglect of the health of the feet of institutionalized elderly persons. There should be more investment in the training of teams responsible for care.
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NewsBot · Aug 17, 2018

Foot pain and foot health in an educated population of adults: results from the Glasgow Caledonian University Alumni Foot Health Survey
Gordon J. Hendry, Linda Fenocchi, Jim Woodburn and Martijn Steultjens
Journal of Foot and Ankle Research: 17 August 2018

Background
Foot pain is common amongst the general population and impacts negatively on physical function and quality of life. Associations between personal health characteristics, lifestyle/behaviour factors and foot pain have been studied; however, the role of wider determinants of health on foot pain have received relatively little attention. Objectives of this study are i) to describe foot pain and foot health characteristics in an educated population of adults; ii) to explore associations between moderate-to-severe foot pain and a variety of factors including gender, age, medical conditions/co-morbidity/multi-morbidity, key indicators of general health, foot pathologies, and social determinants of health; and iii) to evaluate associations between moderate-to-severe foot pain and foot function, foot health and health-related quality-of-life.

Methods
Between February and March 2018, Glasgow Caledonian University Alumni with a working email address were invited to participate in the cross-sectional electronic survey (anonymously) by email via the Glasgow Caledonian University Alumni Office. The survey was constructed using the REDCap secure web online survey application and sought information on presence/absence of moderate-to-severe foot pain, patient characteristics (age, body mass index, socioeconomic status, occupation class, comorbidities, and foot pathologies). Prevalence data were expressed as absolute frequencies and percentages. Multivariate logistic and linear regressions were undertaken to identify associations 1) between independent variables and moderate-to-severe foot pain, and 2) between moderate-to-severe foot pain and foot function, foot health and health-related quality of life.

Results
Of 50,228 invitations distributed, there were 7707 unique views and 593 valid completions (median age [inter-quartile range] 42 [31–52], 67.3% female) of the survey (7.7% response rate). The sample was comprised predominantly of white Scottish/British (89.4%) working age adults (95%), the majority of whom were overweight or obese (57.9%), and in either full-time or part-time employment (82.5%) as professionals (72.5%). Over two-thirds (68.5%) of the sample were classified in the highest 6 deciles (most affluent) of social deprivation. Moderate-to-severe foot pain affected 236/593 respondents (39.8%). High body mass index, presence of bunions, back pain, rheumatoid arthritis, hip pain and lower occupation class were included in the final multivariate model and all were significantly and independently associated with moderate-to-severe foot pain (p < 0.05), except for rheumatoid arthritis (p = 0.057). Moderate-to-severe foot pain was significantly and independently associated lower foot function, foot health and health-related quality of life scores following adjustment for age, gender and body mass index (p < 0.05).

Conclusions
Moderate-to-severe foot pain was highly prevalent in a university-educated population and was independently associated with female gender, high body mass index, bunions, back pain, hip pain and lower occupational class. Presence of moderate-to-severe foot pain was associated with worse scores for foot function, foot health and health-related quality-of-life. Education attainment does not appear to be protective against moderate-to-severe foot pain.
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NewsBot · Oct 31, 2018

Factors associated with prevalent and incident foot pain: data from the Tasmanian Older Adult Cohort Study
L.L. Laslett et al
Maturitas : October 21, 2018

Highlights
•Obesity and pain at multiple joints are consistently associated with existing foot pain and predict new foot pain.
•The link to obesity is likely to be primarily mechanical in nature.
•Reducing obesity in the community may reduce the prevalence of foot pain.
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Objectives
To describe factors associated with prevalent and incident foot pain in a population-based cohort of older adults (n = 1092).

Study design
Longitudinal observational study.

Main outcome measures
Prevalent foot pain, incident foot pain after 5 years.

Methods
Potential correlates included demographic factors, anthropometry, leg strength, metabolic factors, steps per day (using pedometer), pain at 6 other sites, and psychological wellbeing. Data were analysed using log binomial models.

Results
Participants were aged 50–80 years (mean 63 years), 49% male, mean body mass index (BMI) 27.8 ± 4.7 at baseline. The prevalence of foot pain at baseline was 38% and the incidence of new pain over 5 years was 20%. BMI, pain at other sites (neck, hands, knees, pain at three or more sites), and poorer psychological wellbeing were independently associated with baseline foot pain. Baseline BMI and pain in the neck, hands, and knees were independently associated with incident foot pain; but change in weight or BMI, total number of painful joints and psychological wellbeing were not. Self-reported diabetes and cigarette smoking were not associated with prevalent or incident foot pain.

Conclusions
This study demonstrates that greater body weight and joint pain at multiple sites were consistently associated with prevalent foot pain and predict incident foot pain. Addressing excess body mass and taking a global approach to the treatment of pain may reduce the prevalence and incidence of foot pain in older adults.
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NewsBot · Dec 30, 2018

Prevalence of foot pain across an international consortium of population based cohorts.
Gates et al
Arthritis Care Res (Hoboken). 2018 Dec 28.

OBJECTIVE:
Despite the potential burden of foot pain, some of the most fundamental epidemiological questions surrounding the foot remain poorly explored. The prevalence of foot pain has proved difficult to compare across existing studies due to variations in case definitions. The objective of this study was to investigate the prevalence of foot pain in a number of international population-based cohorts using original data and to explore differences in the case definitions used. .

METHODS:
Foot pain variables were examined in five cohorts (the Chingford Women Study, the Johnston County Osteoarthritis Project, the Framingham Foot Study, the Clinical Assessment Study of the Foot and the North West Adelaide Health Study). One foot pain question was chosen from each cohort based on its similarity to the American College of Rheumatology (ACR) pain question.

RESULTS:
The precise definition of foot pain varied between the cohorts. The prevalence of foot pain ranged from 13 to 36% and was lowest within the cohort that used a case definition specific to pain, compared to the four remaining cohorts that included components of pain, aching or stiffness. Foot pain was generally more prevalent in women, the obese and generally increased with age, being much lower in younger participants (20-44 years).

CONCLUSION:
Foot pain is common and is associated with female sex, older age and obesity. The prevalence of foot pain is likely affected by the case definition used, therefore consideration must be given for future population studies to use consistent measures of data collection.
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NewsBot · Mar 26, 2019

Prevalence of Hallux Valgus in general population
Namrata Naik et al
March 2019 Volume 9 Number 3

Purpose: Hallux valgus is relatively common condition, occurring when the hallux deviates laterally towards the
other toes, and the first metatarsal head becomes prominent medially.[1] While development of hallux valgus is
multifactorial, causes are hereditary factor, wearing tight footwears, rheumatoid arthritis or obesity. Women tend to
be affected more than male with sex ratio as high as 9:1 with predominance of Hallux valgus, increases steadily with
age. Muscle imbalance in adductor and abductor of toe muscle was cited as major factor of production of Hallux
valgus. Inappropriate or constricting footwear appears to be primary extrinsic cause, therefore school children and
office individuals have chances of having hallux valgus. Other intrinsic factors play a role as well, it is reported that
pesplanus has some influence on bunion formation also pronation of hindfoot is a major cause of this condition. The
study was conducted to determine the prevalence of hallux valgus and intensity of pain in general population with
help of footboard measurement and goniometer. Method: An Observational study comprising of 110 samples. The
samples were assessed with the help of footboard and goniometer, Results:67% of Female and 44% of male out of
total samples,70% have bilateral hallux valgus and 30% have unilateral hallux valgus and majority of the samples
have grade 1 hallux valgus then grade 2 and 3. Conclusion: It was concluded that women tend to affect more than
male and out of total samples majority of samples have Grade 1 degree of hallux valgus and very few samples have
pain while movement or walking.
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NewsBot · May 22, 2019

Encounters for foot and ankle pain in UK primary care: a population-based cohort study of CPRD data.
Ferguson R et al
Br J Gen Pract. 2019 May 20

BACKGROUND:
Older patients who have foot pain report variation in access to services to manage their foot health. To plan services it is essential to understand the scale and burden of foot pain that exists for GPs.

AIM:
To provide UK-wide population-level data of the frequency of foot and/or ankle pain encounters recorded in general practice.

DESIGN AND SETTING:
Population-based cohort design study using data drawn from the UK Clinical Practice Research Datalink (CPRD) from January 2010 to December 2013.

METHOD:
All CPRD data were collected prospectively by participating GPs. The primary outcome was prevalence of GP encounters for foot and/or ankle pain, stratified by age, sex, and different subgroups of causes.

RESULTS:
A foot and/or ankle pain encounter was recorded for 346 067 patients, and there was a total of 567 095 recorded encounters (mean per person 1.6, standard deviation [SD] 1.3). The prevalence of recorded encounters of foot and/or ankle pain was 2980 per 100 000 (3%). The number of patients with a recorded encounter of foot and/or ankle pain was 1820 per 100 000 (1.8%). Foot and/or ankle pain encounters were reported across all age groups (54.4% females), with those aged 71-80 years placing the greatest burden on GPs. The most common specified referrals were to orthopaedics (n = 36 881) and physiotherapy (n = 33 987), followed by podiatry (n = 25 980).

CONCLUSION:
The burden of foot and/or ankle pain encounters recorded by GPs is not insubstantial, and spans all ages, with a high proportion of referrals to orthopaedics. The authors recommend further exploration of 'first-contact practitioners' for foot and/or ankle pain in general practice to alleviate the burden on GPs.
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NewsBot · Nov 17, 2019

The prevalence and impact of self-reported foot and ankle pain in the over 55 age group: a secondary data analysis from a large community sample
Anne-Maree Keenan, Chris Drake, Philip G. Conaghan & Alan Tennant
Journal of Foot and Ankle Research volume 12, Article number: 53 (2019)

Background
While the prevalence and impact of musculoskeletal problems are high, most attention has been directed towards the back, knee and hip disorders. Foot pain is known to be common in older adults and accounts for a significant burden on health services. The aim of this study was to assess the impact of foot and ankle joint pain, considering age, presence of co-morbidities and other site joint pain, in a large community sample.

Methods
In the North Yorkshire Health study, 16,222 people over 55 years participated in a detailed survey of the prevalence and impact of lower limb joint problems. Self-assessment of overall body pain and functional activities of daily living were assessed. Participants indicated the presence of joint pain, stiffness or swelling during the last 3 months which had lasted for more than 6 weeks on a manikin: data were captured on the foot and the ankle.

Results
The prevalence of self-reported foot and ankle joint pain was substantial: 184.33 per 1000, second only to knee problems. While foot pain was common, it was mostly associated with joint pain at other sites; only 1 in 11 of those with foot and ankle pain reported it only in the foot. Logistic regression modeling revealed while established factors such as co-morbidities, knee and hip problems contributed to functional impairment, foot and ankle problems contributed to an additional increased risk of having difficulty standing and walking by two fold (OR = 2.314, 95%CI 2.061–2.598), going up and down stairs by 71% (OR = 1.711, 95%CI 1.478–1.980) and getting up from a seated position by 44% (OR = 1.438, 95%CI 1.197–1.729).

Conclusion
These results suggest that not only are foot problems in the over 55 age group extremely prevalent, they have a considerable impact on functional abilities.
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NewsBot · Mar 2, 2020

Radiographic Prevalence of a Pedal Deformity.
DiCosmo, Alyssa M.; Sathe, Vinayak
Connecticut Medicine . Feb2020, Vol. 84 Issue 2, p73-76. 4

A bunionette deformity is defined as a painful bony prominence over the lateral head of the fifth metatarsal. Although the literature frequently mentions bunionette deformity in conjunction with hallux valgus (HV), a similar structural deformity of the first metatarsophalangeal joint, no statement exists regarding the frequency of both deformities occurring in the same patient. Because both deformities change the biomechanics of the foot, correcting only HV leaves the potential for the smaller, uncorrected bunionette deformity to impact surgical outcomes. A retrospective evaluation was performed to evaluate the prevalence of radiographic bunionette deformity in patients with HV. Of the 117 feet with HV, 40 (34.2%) had a radiographic tailor's bunion. In total, 42.5% of the identified radiographic bunionette deformities did not have accompanying ICD-10 codes on preoperative documentation. Thus, bunionette deformity frequently goes undiagnosed in patients with HV.
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NewsBot · Apr 26, 2020

Foot and Ankle Abnormalities Among a Cohort of Nigerian School Children: An Epidemiological Study
A Bafor, C N Chibuzom
Int Orthop. 2020 Apr 23

Purpose: Foot and ankle problems in children are a common cause for paediatric orthopaedic referrals. There is a variation in the reported epidemiology of foot and ankle abnormalities across the globe. The prevalence in our locality was unknown. The objective of this study was to determine the prevalence pattern of foot and ankle problems in our locality as well as compare with patterns from other geographical locations to determine the presence or otherwise, of differences among varying populations.

Methods: One thousand seven hundred and fifty-eight Nigerian primary school children aged between five and 13 years were clinically evaluated, checking for weight, height and calculation of BMI. The heel axis angle and hallux angle were measured clinically while determination of flatfeet or high arched feet was made from analysis of foot imprints.

Results: Hindfoot valgus was the commonest abnormality of the foot and ankle in this population with a prevalence of 34.2% and predominantly in females and older children, while hallux valgus and a high arched foot were the least common abnormalities at 0.6 and 0.7% prevalence rates, respectively. We found no statistically significant relationship between BMI and hindfoot valgus.

Conclusion: Hindfoot valgus is the commonest foot and ankle abnormality among primary school children in our locality.
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NewsBot · Apr 29, 2020

Foot health among the Roma population of southern Spain according to the foot health status questionnaire.
Coheña-Jiménez M et al
BMC Public Health. 2020 Apr 6;20(1):462

BACKGROUND:
Foot health of the Roma population is a challenge for the health professionals where this minority is significant, as is the case in Spain. At present, little is known about foot health of the Roma population and their knowledge would promote the training of these professionals at the community level. Foot pain is common and a reason for consulting podiatry services. The purpose of this study was to determine foot health among the Roma population according to the Foot Health Status Questionnaire.

METHOD:
An observational, cross-sectional and quantitative study conducted at the Roma population living in Spain in 2018. Self-reported data and the Foot Health Status Questionnaire were recorded. Examining the general health and foot health (foot pain, foot function, footwear and general health) and general (general health, social capacity, physical activity and vigour). This questionnaire is recommended as a valid and reliable patient-reported outcome. The obtained scores were compared.

RESULTS:
A sample made up of 624 men and women from the Roma population took part in this study. 45% were Roma men and 55% Roma women. In the first section of the FHSQ, a lower score of values was recorded in the footwear domain (62.5) and in the general foot health domain (60). Gypsy women obtained lower scores in all the domains. In the second section, lower scores were obtained in the vigour (56) domain and in the general health (60) domain. A large effect size (r-Rosenthal) was found by gender in the footwear domain (0.334) and in the vigour domain (0.195). Roma women showed higher values in cardiac disorders, serious illnesses, doctor visits and foot problems. 67.8% reported that they had never been assisted by a podiatrist.

CONCLUSIONS:
The studied Roma population has foot health problems, and these are more pronounced among women. They show lower values in the footwear and vigour domains. More professional training is required for health workers in this field to avoid cultural diversity stereotypes.
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NewsBot · Oct 7, 2020

The prevalence of foot pain and its associated factors among Saudi school teachers in Abha sector, Saudi Arabia.
Alqahtani TA.
J Family Med Prim Care 2020;9:4641-7

Background: The heel is the prominence at the posterior end of the foot. It is based on the projection of one bone, the calcaneus or heel bone, behind the articulation of the bones of the lower leg. Foot pain is not rare finding in the general population, particularly in older adults. The prevalence in adults ages ≥18 year's ranges from 17 to 24%. Heel pain is a general term used to describe pain and discomfort felt anywhere in or around the rear of the foot. This study aimed to estimate the prevalence of heel and foot pain and their determinants among teachers in Abha sector. Methodology: A deceptive cross-sectional approach was applied for the current research. All accessible teachers working in governmental and private schools in Abha sector. To be included, teachers should be teaching but not in administrative positions, free of musculoskeletal disorders due to causes other than teaching. Teachers with foot congenital anomalies, newly employed teachers. A self-administered questionnaire was personally distributed to included school teachers in Abha sector. Questionnaires were distributed and collected on second day after being filled by teachers. Posterior HP health Survey questionnaire was used to assess foot and foot pain. Results: The study included 1,439 teachers from different districts of Abha sector with their ages ranged from 24 to 60 years old with mean age of 41 ± 9 years. Female teachers constituted 72.8% of the sample and teachers' weight ranged from 45 to 185 kg with mean weight of 76.6 ± 18.2 kg. Exact of 85.5% of the teachers had foot pain during the last 12 months. Foot pain was mild among 17.3% of the teachers with foot pain and severe among 25.5% of them. Low back pain was recorded among 81% of the teachers followed with knee pain (62%), neck pain (58%), shoulder pain (55%), and wrist pain (28%). Conclusions and Recommendations: In conclusion, the study revealed that majority of teachers complained of foot pain. The pain was moderate especially after long standing. The pain was more among old aged teachers with high load of teaching sessions. The pain altered the traditional daily activities among majority of teachers but very few number who asked for medical consultation.
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NewsBot · Sep 8, 2021

Prevalence of Hallux Valgus in Normal Individuals
Krishna B. Gawande et al
Journal of medical pharmaceutical and allied sciences, Volume 10 - Issue 4, 1263, July - August 2021, Page - 3138-3141

To find out the prevalence of hallux valgus in normal individuals. The lateral deviation of the big toe at the first metatarsophalangeal joint is
also known as Hallux valgus and is frequently common in women’s. The primary function of the foot is to control the body weight and to serve as a
part of lever for its proper functioning. Basically body weight and the strain falls along with the center of the foot and maintain the balance there by
surrounding muscular activity. By any chance if this normal synchronization is disturbed in the performance of their function, in spite of accommodative
power of nature to disease and deformity. Cross sectional study 200 male and female with or without foot pain were included. 38.59% and 31.46% of
male and female have hallux valgus of right foot out of total samples. 45.61% and 39.15% of male and female have hallux valgus of left foot out of
total samples. The result of the study concluded that the prevalence of hallux valgus deformity was greater in older aged group than young aged group
and among which showed left foot was more commonly affected in both males and females. It also showed that it does not affect functional activity in
normal young individual.
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NewsBot · Oct 10, 2022

Relationship between physical activity and musculoskeletal disorders among low income housewives in Kuala Lumpur: A cross sectional study
N Z M Saat et al
PLoS One. 2022 Oct 6;17(10)

Housewives play a crucial role in their families' and communities' quality of life. However, musculoskeletal disorders are common among housewives due to housework and lack of physical activity. These musculoskeletal problems have been associated to leisure physical activity. As a result, the goal of this study was to determine the incidence of musculoskeletal problems and their association to physical activity among low-income women in Kuala Lumpur. A cross-sectional research was done among 82 housewives in Kuala Lumpur's low-income housing area. Housewives were asked to fill out a sociodemographic questionnaire, a short version of the International Physical Activity Questionnaire (IPAQ), the Nordic Musculoskeletal Questionnaire (NMQ), and body mass index were measured by researcher. The total prevalence of musculoskeletal problems was found to be 89.0%, with the lowest frequency in the lower back (35%), followed by the knee (31%), ankle or foot (31%), and elbow (1% %). The subjects spent an average of 117.6 + 474.8 minutes per week on MVPA and 524 + 810.3 MET minutes per week on physical activity. A total of 88% of the participants had a low level of physical activity, 8.5 percent had a moderate level of activity, and 3.7% had a high level of activity. In a Chi-square test, there was no significant association between musculoskeletal problems and physical activity. The primary sociodemographic factors impacting musculoskeletal diseases were body mass index and household income, while the primary variables influencing physical activity were household income and education level, according to a logistic regression test. In a Poisson regression test, only body mass index had a significant relationship with number of musculoskeletal disorders. In conclusion, housewives are likely to suffer from musculoskeletal problems, with a high incidence in the lower back, knees, ankles, and feet, and the majority of them engage in little physical activity. Furthermore, the high percentage of musculoskeletal problems in this study varies with the findings of other research based on the type of housework done by housewives in low-cost housing areas. Future research should look at identifying the sorts of household tasks and positions employed, as well as the amount of hours spent on housework each week.
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NewsBot · Nov 7, 2022

Foot, ankle, and leg problems in Australian primary care: consultation patterns, management practices, and costs
Hylton B Menz et al
Fam Pract. 2022 Nov 2

Objective: To explore consultation patterns, management practices, and costs of foot, ankle, and leg problems in Australian primary care.

Study design: We analyzed data from the Bettering the Evaluation and Care of Health program, April 2000 to March 2016. Foot, ankle, and leg problems were identified using the International Classification of Primary Care, Version 2 PLUS terminology. Data were summarized using descriptive statistics examining general practitioner (GP) and patient characteristics associated with a foot, ankle, or leg problem being managed. Cost to government was estimated by extracting fees for GP consultations, diagnostic imaging, and pathology services from the Medicare Benefits Schedule (MBS) database. Costs for prescription-only medicines were extracted from the Pharmaceutical Benefits Schedule and for nonprescribed medications, large banner discount pharmacy prices were used.

Results: GPs recorded 1,568,100 patient encounters, at which 50,877 foot, ankle, or leg problems were managed at a rate of 3.24 (95% confidence intervals [CIs] 3.21-3.28) per 100 encounters. The management rate of foot, ankle, or leg problems was higher for certain patient characteristics (older, having a health care card, socioeconomically disadvantaged, non-Indigenous, and being English speaking) and GP characteristics (male sex, older age, and Australian graduate). The most frequently used management practice was the use of medications. The average cost (Australian dollars) per encounter was A$52, with the total annual cost estimated at A$256m.

Conclusions: Foot, ankle, and leg problems are frequently managed by GPs, and the costs associated with their management represent a substantial economic impact in Australian primary care.
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NewsBot · Jan 16, 2023

PREVALENCE OF HALLUX VALGUX DEFORMITY IN
ADULTS
Aimen Javed et al
Journal of Xi’an Shiyou University, Natural Science Edition ISSN: 1673-064X

Background: Hallux valgus is common foot
deformity in adult population , hallux valgus
deformity is also known as splay foot or
bunion .In this deformity big toe move to
lateral side of the foot and protruding of the
first metatarsal bone to outside and angle
between big toe and second is decrease.
Objective of this current study was to
evaluate the prevalence of hallux valgus
deformity in adults.
Method: This is a cross sectional study was
done through non probability sampling
technique. Taking history on Performa from
215 different age group participants from 18 -
50 year old who were selected to the general
population of district Punjab Gujarat of
Pakistan . Goniometer and VAS Scale is use
to find out the hallux valgus deformity of foot
in adult and their level of pain . Descriptive
method of statistics was used for frequency
and Percentage . Data analysis was done in
IBM SPSS Statistics 21.
Result: Sample of 112 female participants
and 103 male participants included , left foot
of female was more effected male having
47.9% of hallux valgus and female having
52.1% . Left foot 54.0% , bilateral foot
28.4% show hallux valgus deformity,
Occupations students having30.2% of hallux
valgus deformity, house wife showed 27.0% ,
and 80.5% of participant having hallux valgus
deformity statistical significant p-value
<0.001, BMI body mass index of participants
having 30.14±5.26 .
Conclusion: Hallux valgus deformity is more
common in younger adult as compare to older
and there severity is varied from person to
person but most of them having mild
deformity without any pain but having pain
when they put their feet in shoes for most of
the time. Result show that hallux valgus 20
degree is more common in adult female
population , foot wear , weight , shoes shape
play major role in the formation of hallux
valgus deformity of foot
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NewsBot · Jan 29, 2023

Clinical characteristics analysis of 22 062 patients of foot and ankle deformity from QIN Sihe Orthopaedic Surgery Database between May 25, 1978 and December 31, 2020
Sihe Qin etal
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Jan 15;37(1):74-80.

Objective: Based on the clinical data of patients with foot and ankle deformities in the QIN Sihe Orthopaedic Surgery Database, to analyze the characteristics and treatment strategies of foot and ankle deformities, and provide a basis for clinical decision-making.

Methods: A total of 22 062 patients with foot and ankle deformities who received orthopedic surgery between May 25, 1978 and December 31, 2020 were searched in the QIN Sihe Orthopedic Surgery Database. The gender, age at operation, regional distribution, etiology, type of deformity, operation method, postoperative fixation method, and other information were collected.

Results: Among the 22 062 patients, there were 13 046 males (59.13%) and 9 016 females (40.87%); the age at operation ranged from 1 to 77 years, with a median of 17 years, and 20 026 cases (90.77%) were aged 5 to 40 years. The patients came from 32 provinces, municipalities, and autonomous regions across the China and 5 countries including India and the United States, et al. The etiology and diseases type covered 154 kinds (of which sequelae of poliomyelitis, cerebral palsy, spina bifida and tethered spinal cord, congenital equinovarus foot, post-traumatic foot and ankle deformity, and Charcot-Marie-Tooth disease accounted for the highest proportion). The types of deformities included varus foot, equinus foot, valgus foot, talipes calcaneus, equinocavus, high arched foot, claw toe, and flail foot. Surgical methods included tendon lengthening, soft tissue release, tendon transposition, osteotomy orthopedics, and ankle arthrodesis. The 36 620 operations were performed, including 11 561 cases of hip, knee, and lower leg operations to correct the foot and ankle deformities. Postoperative fixation methods included Ilizarov external fixator in 2 709 cases (12.28%), combined external fixator in 3 966 cases (17.98%), and plaster or brace fixation in 15 387 cases (69.74%).

Conclusion: Male patients with foot and ankle deformities account for a large proportion, and the population distribution is mainly adolescents, with a wide distribution of regions, causes and diseases, and talipes equinovarus and varus foot are the main types of deformities. Foot and ankle deformities are often combined with deformities of other parts of the lower limb, which requires a holistic treatment concept. The application of foot soft tissue and bone surgery combined with Ilizarov external fixator and combined external fixators provides a guarantee for the correction of complex foot and ankle deformities.
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NewsBot · Sep 21, 2023

Foot problems in older persons attending a day hospital Get access Arrow
G Carey, E Farrell, M Crowe
Age and Ageing, Volume 52, Issue Supplement_3, September 2023, afad156.124, https://doi.org/10.1093/ageing/afad156.124

Background
Foot problems may contribute to pain and falls in older people. We documented the prevalence of foot problems in older persons attending a Day Hospital for rehabilitation.

Methods
Symptoms of foot pain and prevalence of foot problems and inappropriate footwear were documented by 2 physiotherapists using a ‘foot problem score’ in consecutive referrals by consultant geriatricians to an offsite day hospital with rehabilitation expertise over a 3-month period. Subjects were categorised into 2 groups depending on whether they had none/only one fall or multiple falls in previous 12 months.

Results
Sixty-seven patients, age 72–93 years were included in the study. The most common foot problem was hallux valgus in 62 patients (93%) of whom 41(66%) and 4(6.5%) had moderate or severe deviation respectively. Other findings included corn/callus in 37(55%) patients, toenail abnormality in 30(44.7%) whilst only one patient was found to have an ulcer. Seventeen patients (25.4%) complained of painful feet. Twenty-nine patients (43%) were multiple fallers (2 or more falls in previous 12 months) of whom 13(44.8%) complained of foot pain compared to only 4/38(10.5%) of patients with none or only one fall over previous 12 months complaining of foot pain (p = 0.0014). Footwear was deemed inappropriate in 18.8% of patients whilst 56.3% were attending chiropody.

Conclusion
The higher prevalence of foot problems and foot pain in this survey compared to a similar survey (1) in community dwelling older persons may reflect increased comorbidities in this day hospital population and the adverse effects of foot pain on balance and function. Foot and footwear assessment should be incorporated into comprehensive geriatric assessment.
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