Heel Pain That Won’t Quit
Heel pain can creep on you and then suddenly it’s a major issue. You may notice it in the morning when you first rest your weight on the floor, or after you’ve been on your feet for a long time— working or jogging, for instance. What starts out as a minor issue, however, can turn ugly when it persists for months.
Plantar fasciitis, pronounced plant-ar fashee-itis, is one common cause of heel pain.
About one in ten Americans have this disorder. It happens when the ligament that supports the arch in your foot is strained. The pain lets up somewhat when you start moving around because walking helps to stretch the ligament. But in most cases, the pain gets worse as the day goes on.
Originally it was thought that plantar fasciitis was caused by inflammation, but now it’s believed to be a degenerative process— which is why it’s more common in middle-aged people than the young. Plantar fasciitis can be a real challenge.
Some of my patients report they’ve changed their work-out routine and basically stopped walking, to no avail.
It helps to customize the treatment approach. We’ve found that treatments vary in effectiveness from one patient to another. This is because everyone’s feet are unique— one may have flat feet, while another has a high arch— depending on anatomy and what those feet have to endure.
Your doctor can usually diagnose the problem with a physical exam and asking about your history and lifestyle. Sometimes an x-ray will be ordered, to see if a bone spur is forming on the heel— although bone spurs are not usually the source of the pain.
Plantar Fasciitis Therapy to Begin the Healing Process
There are a handful of conservative heel pain treatments . Besides the pain relievers, rest and ice packs, we sometimes tape the foot to support the ligament. A special splint can be worn at night to stretch the calf muscles and relieve tension on the ligament. Cortisone injections may provide temporary relief. Radiofrequency waves are also used to interrupt nerve signals and relieve pain.
It’s important to choose your footwear carefully. You need shoes with good arch support, with heels no higher than one inch. If you can feel the pavement through the soles of your shoes, the shoes are not providing enough support. Avoid going barefoot.
You may also have to adjust your activities, switching to bicycling or swimming, for instance, instead of running, golf, or other sports that put stress on your feet. Any activity that involves pounding on hard pavement should be avoided.
Specific exercises may help. Researchers in Scandinavia had patients stand in their bare feet on a stair or a box with a rolled-up towel beneath the toes of the sore foot and the heel hanging over the edge of the stair or box.
Then the patients slowly raised and lowered the sore heel. When the patients could do this exercise twelve times without pain, they saddled themselves with on backpacks full of books to add weight. After performing these exercises eight to twelve times every other day, the patients reported significant improvement.