Foot Problems in Older Adults: Common Conditions and Why Regular Podiatric Care Matters

Quick answer: Foot Problems Older Adults Seniors Podiatry is a common foot/ankle topic that affects many patients. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Call (810) 206-1402.

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Foot problems are remarkably prevalent among older adults — studies estimate that 77% of adults over age 65 have at least one foot condition, yet fewer than 40% have ever sought professional foot care. This gap matters enormously, because many of the foot problems that are most common in older adults can lead to falls, reduced mobility, social isolation, and serious medical complications — all of which are preventable with appropriate podiatric care.

Why Feet Age Differently

The changes that aging brings to the feet are physiologically distinct from the rest of the body:

• Fat pad atrophy — the plantar fat pad thins with age, reducing the natural cushioning under the heel and ball of the foot by 20–30%
• Ligamentous laxity — years of bearing body weight causes gradual stretching of foot ligaments, contributing to arch flattening and increased forefoot width
• Skin changes — reduced sebaceous (oil) gland activity, thinning dermis, and decreased cell turnover increase dryness, cracking, and bruising susceptibility
• Nail changes — toenails become thicker, harder, and more opaque with age; often difficult to self-trim; become vulnerable to fungal infection
• Circulatory changes — peripheral circulation decreases with age, slowing wound healing and reducing the immune defense against infection
• Neurosensory changes — reduced vibration and proprioceptive sensitivity increases fall risk from impaired balance feedback

The Most Common Foot Problems in Older Adults

Bunions and Hammertoes

Bunions affect an estimated 36% of adults over age 65. Progressive throughout life, bunions in older adults cause significant shoe-fitting difficulty and limit activity. Hammertoes — flexion contractures of the lesser toes — develop alongside bunions and become increasingly rigid with age. Conservative management (wide toe box shoes, custom orthotics, padding) remains effective for symptom control in most patients.

Toenail Fungus

Onychomycosis affects approximately 30–35% of adults over 70. Thickened, fungal nails in older adults are difficult or impossible to trim safely at home, create pressure sores from footwear, and can harbor infection. Regular professional nail care by a podiatrist prevents nail-related wounds and keeps nails safely trimmed.

Diabetic Foot Complications

The prevalence of diabetes increases dramatically with age — over 25% of Americans over 65 have diabetes. Diabetic neuropathy, peripheral arterial disease, and impaired immune function create the triad of conditions that cause diabetic foot ulcers and amputations. Annual comprehensive diabetic foot exams — including monofilament testing, vascular assessment, and nail and callus care — are the cornerstone of amputation prevention. Medicare covers annual diabetic foot exams and therapeutic footwear.

Plantar Fasciitis and Heel Pain

Heel pain from plantar fasciitis and fat pad atrophy is extremely common in older adults and significantly limits walking ability. Custom orthotics with deep heel cups are highly effective for both conditions and are covered by Medicare when medically indicated.

Peripheral Arterial Disease

PAD increases in prevalence with age — affecting approximately 12–20% of adults over 70. Reduced pedal blood flow causes toe and foot pain with activity (claudication), wound healing impairment, and risk of critical limb ischemia. A podiatrist screening for PAD with ankle-brachial index (ABI) measurements can identify patients who need vascular referral before a minor foot wound becomes a limb-threatening problem.

Falls and Balance

Foot problems significantly contribute to fall risk in older adults — 30% of falls in the elderly are attributed to foot and ankle conditions. Foot pain alters gait, reduces walking speed, and increases postural instability. Custom orthotics, appropriate footwear, and treatment of foot conditions that impair proprioception can meaningfully reduce fall risk.

Medicare Coverage for Senior Foot Care

Medicare Part B covers several podiatric services for qualified patients:

• Routine nail care for patients with diabetes, peripheral neuropathy, or peripheral vascular disease
• Annual comprehensive diabetic foot examination
• Custom orthotics when medically necessary
• Therapeutic diabetic shoes and inserts (one pair annually) for qualifying diabetic patients
• Treatment of foot conditions (ingrown nails, warts, plantar fasciitis, etc.) when medically necessary

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your foot and ankle conditions, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

Frequently Asked Questions

When should I see a podiatrist?

If symptoms persist past 2 weeks, affect your normal activity, or are accompanied by red-flag symptoms (warmth, redness, swelling, inability to bear weight).

What does treatment cost?

Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Out-of-pocket costs vary by your specific plan.

How quickly can I get an appointment?

Most non-urgent cases see us within 5 business days. Urgent cases (sudden pain, possible fracture) typically same or next business day.