From the Burke Rehabilitation Hospital, White Plains, New York (MO-P); Department of Rehabilitation Medicine, Montefiore Health System, Albert Einstein College of Medicine, New York, New York (MO-P, DDJK); Hospital for Special Surgery, New York, New York (JK, DA); and Weil Cornell Medical College, New York, New York (JK, DA).
Am J Phys Med Rehabil. 2019 Sep;98(9):811-819. doi: 10.1097/PHM.0000000000001239.
Painful foot disorders are highly prevalent among older adults causing a significant impact on mobility, function, and risk of falls. Despite its significance, foot pain is often interpreted as a normal part of aging and relatively ignored by health care providers as well as by the older people themselves. Accurate diagnosis of the cause of foot pain is possible for most cases via clinical evaluation without a costly workup. Clinicians should consider, not only musculoskeletal pathologies but also vascular and neurological disorders in older patients with foot pain. Fortunately, most patients improve with physiatric, nonoperative interventions involving biomechanical analysis, function-oriented rehabilitation programs and therapeutic exercise, the use of proper footwear and orthoses, and selected percutaneous interventions, as indicated. In this review, we discuss the physiologic changes of the aging foot relevant to foot pain, the impact of painful foot disorders on function and other key outcomes, and principles of diagnosis and intervention. We also briefly describe painful foot disorders of the older people commonly encountered in a physiatric practice.
老年人中足部疼痛疾病的发病率很高，这对他们的活动能力、功能和跌倒风险都有重大影响。尽管足部疼痛意义重大，但它常常被认为是衰老的正常现象，医疗保健提供者以及老年人自身都相对忽视了它。通过临床评估，大多数情况下都可以对足部疼痛的病因进行准确诊断，而无需进行昂贵的检查。临床医生应考虑，不仅是骨骼肌肉病理学，而且还应考虑老年足部疼痛患者的血管和神经疾病。幸运的是，大多数患者通过物理治疗、非手术干预，包括生物力学分析、以功能为导向的康复计划和治疗性运动、正确的鞋类和矫形器的使用以及有选择的经皮介入，都可以得到改善。在这篇综述中，我们讨论了与足部疼痛相关的衰老足部的生理变化、足部疼痛疾病对功能和其他关键结果的影响，以及诊断和干预的原则。我们还简要描述了物理治疗实践中常见的老年人足部疼痛疾病。
