I'm 33 for whatever that's worth. I had to think about it for a second. Crazy how you're asked that less as you get older.
I went from SPD to the SPD-SL pedals (I had an adapter to use these shoes) thinking the larger platform might spread out some of the force, but I can't tell that it did much. I also experimented with cleat placement, but these Fizik shoes only allow the cleat to be moved forwards/backwards so it was a short test.
Usually I keep the front velcro strap as loose as I can and then the ratchet closure part just snug enough to keep my foot from sliding in/out. I had started out with them really tight, but found myself loosening each time trying to reduce the numbness.
The general consensus seems to be swap shoes since these are so narrow and that Shimanos are wider. I guess I'll be looking around for shoes. Any other brands I should keep an eye out for?
Thanks everyone.