Heel pain is the most common foot problem I treat in the office. You know, pain in the heel with the first steps out of bed in the morning. Pain that sometimes lessens after you are on your feet, but then returns with a vengeance when you stand up again. I’m sure you or someone you know has suffered with this. Heel pain usually occurs with no notable trauma or injury to the foot. It just starts. And, if you are like most people, you think it will go away on its own. However, it is usually not that easy. So be proactive and start to address this problem early on.
If you have pain in the bottom of your heel with no history of recent trauma, try this regimen as soon as it starts:
1. Stretch at least 3 times daily (toes flexed up toward the nose and held for 30 seconds or more)
2. Ice (freeze a water bottle and roll it under the foot at the end of the day)
3. Avoid unsupported walking (no barefeet, no sock or slipper walking, no flip flops or sandals, etc.)
4. Supportive shoes (sneakers, etc.)
5. NSAIDs (Ibuprofen, Naprosyn, etc., if you are able to take these)
If you are not improving within two weeks, call for an appointment. Your foot can then be evaluated in a variety of ways. An x-ray can show bone spurs, etc. or a diagnostic ultrasound can show inflammation of the plantar fascia ligament, which attaches to the heel.
In the office setting, there are many treatment options available. Injections, physical therapy, night splints, walking boots and inserts can be considered. Podiatrist recommended inserts are a gold standard treatment for this problem. Both over the counter and custom inserts are options depending on your foot type and symptoms.
Shockwave therapy is also an in office treatment that is used for chronic heel pain not responding to the above treatments. It is an in office treatment that requires no cutting or incisions. There is minimal down time following this treatment.
A last resort for treatment of chronic heel pain not responding to conservative care is surgery.