5 Causes of Foot Pain in Active Adults Over 60—and What to Do About Each One

KEY TAKEAWAYS

• Foot pain in active adults over 60 is common, but it is not inevitable or permanent.
• The five conditions most likely to cause discomfort in this age group—plantar fasciitis, Achilles tendinopathy, osteoarthritis, metatarsalgia, and peripheral neuropathy—all have effective
• non-invasive or minimally invasive treatment options available.
• Early evaluation and appropriate care can keep you moving and doing the things you love.

You’ve spent decades hiking, running, cycling, or simply staying on your feet, and you’re not ready to slow down. But something has shifted. There’s a new pain in the arch after your morning walk, stiffness in the heel that takes longer to ease, or aching in the ball of the foot after a day in the garden.

Senior foot pain is one of the most common reasons adults over 60 visit Alpine Foot & Ankle Clinic, and the good news is that most of these conditions respond well to non-surgical care, even when they’ve been present for a while. Here are the top five causes of foot pain Missoula podiatrist Dr. Gregg Neibauer sees most often in active adults over 60, and how to address each.

1.   Plantar Fasciitis

Plantar fasciitis is the most common cause of heel pain in adults of all ages. It becomes more prevalent in the 60s as the plantar fascia (the thick band of tissue running along the bottom of the foot) loses its elasticity and becomes more prone to small tears under repetitive load.

What it feels like:

Sharp or aching heel pain that is worst with the first steps in the morning, improving with movement but often returning after prolonged standing or at the end of an active day.

What to do:

Conservative options such as stretching protocols, supportive footwear, and custom orthotics resolve many cases of plantar fasciitis when applied early. For cases that have become chronic or have not improved with initial care, shockwave therapy (EPAT) and laser therapy are effective non-surgical options with no downtime.

2.   Achilles Tendinopathy

The Achilles tendon—the largest tendon in the body—endures enormous repetitive force with every step, run, and climb. In adults over 60, the tendon’s ability to recover from that load diminishes, and degenerative changes in the tendon tissue itself can develop even without a specific injury.

What it feels like:

Stiffness and aching at the back of the heel and lower calf, typically worse in the morning and after periods of rest. Some patients also experience swelling or a visible thickening of the tendon.

What to do:

Eccentric stretching exercises are among the most evidence-supported interventions for Achilles tendinopathy and can be effective when performed consistently. For patients with persistent or severe symptoms, non-surgical therapies, including shockwave and laser therapy, can stimulate tissue repair and reduce pain. Custom orthotics with heel lifts may also reduce tendon strain during daily activities.

3.   Osteoarthritis of the Foot and Ankle

Osteoarthritis—the gradual breakdown of joint cartilage—is among the most common causes of foot pain in adults over 60. The joints most frequently affected in the foot include the big toe (hallux), the midfoot, and the ankle. Past injuries, including old ankle sprains, can accelerate the development of arthritis in specific joints.

What it feels like:

Deep, aching joint pain that worsens with activity and may be accompanied by stiffness after rest, swelling around one or more joints, and a reduced range of motion. The big toe joint may feel stiff and painful when pushing off during walking.

What to do:

Supportive footwear with a stiff rocker-bottom sole can reduce stress on arthritic foot joints. Custom orthotics designed for arthritic feet redistribute pressure away from painful areas. For inflammation and pain, laser therapy and stem cell therapy may help reduce pain and support joint tissue health. Activity modification also plays a role in symptom management; try switching high-impact activities like running to lower-impact alternatives, such as cycling or swimming, during flare-ups.

4.   Metatarsalgia

Metatarsalgia is a broad term for pain and inflammation in the ball of the foot, directly behind the toes. In older adults, the fat padding beneath the metatarsal heads thins naturally, reducing the foot’s built-in cushioning and leaving the bones more exposed to pressure during weight-bearing activity.

What it feels like:

A burning or aching sensation in the ball of the foot, often described as feeling like you’re walking on pebbles. Pain tends to worsen with prolonged standing, walking, or other activities that put weight on the forefoot.

What to do:

Footwear with a wide, cushioned toe box and adequate forefoot cushioning is a critical first step. Custom orthotics with metatarsal pads can redistribute pressure away from painful areas. For active patients, avoiding thin-soled shoes and replacing worn athletic footwear make a significant difference. If a Morton’s neuroma is contributing to the discomfort, Dr. Neibauer can evaluate for this and recommend targeted treatment.

5.   Peripheral Neuropathy

Peripheral neuropathy (damage to the nerves in the feet and lower legs ) can have many causes, with diabetes being the most common. However, it can also result from vitamin deficiencies, thyroid conditions, certain medications, and circulatory issues. It is increasingly common with age, regardless of diabetes status.