Every day, I see two or three patients complaining of pain in the bottom of their heels and arches. Pain ranges from mild, occasional discomfort to cases so extreme that it causes a person to walk with a limp. Now that summer has finally arrived, complaints become more common and more severe.
Warmer weather brings increased activity levels, and all of the associated health benefits. Unfortunately, this also leads to increased heel pain. Patients frequently experience a Catch 22: They need to exercise for health reasons, but the more they exercise, the more their feet hurt. Making matters worse, many people wait months before seeking medical treatment, prolonging their discomfort.
Typically, people complain of pain when they first get out of bed in the morning. This will range from general stiffness to sharp, excruciating pain. After a few minutes of walking with the support of a good sneaker, the pain may subside. However, people often find that if they have been sitting down or relaxing on the couch, the pain resumes upon standing. While sitting, the feet are not as flat because there is no weight on them. This allows the plantar fascia – a band of connective tissue that runs along the bottom of the foot — to contract and shorten. It will stay in this shortened position until the feet bear weight, at which point the plantar fascia stretches as much as possible. Normally, this is not problematic, but with increased activity and age the structure becomes tighter and less flexible. Rather than stretching, the structure may tear, causing pain that can extend from the back of the heel into the arch of the foot.
Fortunately, heel pain can be addressed by numerous treatment options. Stretching is an important part of the treatment regimen, with certain exercises specifically targeting the plantar fascia. Taking ibuprofen or aspirin can usually provide some relief, but heel pain persisting more than two weeks warrants a visit to our office for definitive diagnosis and treatment. Ninety percent of patients with heel pain can be treated conservatively with taping, custom orthotics, physical therapy or cortisone.