A common cause of chronic heel pain is called plantar fasciitis (plant-ar’ fash’-e-itis).
This is an inflammation of the band of tissue (called the plantar fascia) that runs along the bottom of your foot from the toes to the heel. One way to remember is by the name: the foot is planted on the ground.
It’s believed that the structure of the foot is responsible for this disorder, which happens when the ligament that supports the arch in your foot is strained. In some patients, heel pain is accompanied by a bone spur but this is not a cause of pain, just a source of irritation if the bone spur is rubbing against your shoe. Other, less common reasons for foot pain include arthritis, nerve irritation, stress fracture or tendonitis.
Plantar fasciitis pain is often worse right after you get out of bed in the morning or after you’ve been sitting for a long time. After a few minutes, the fascia become stretched and the pain subsides.
And in fact, that’s one component of heel pain treatment— exercises to stretch the fascia.
Doctor can diagnose the problem, ask about your job and/or physical activities and perhaps order x-rays to check for bone spurs. Treatment must be customized for each patient because nobody’s feet are identical— one may have long feet, while another has a high arch, etc.
Non-Surgical Treatments for Heel Pain
Losing weight often helps relieve foot pain but, ironically, foot problems also plague active people. Runners are especially prone to plantar fasciitis. If you’ve taken up a new activity such as tennis that involves repetitive impact, you may need to cut back for a while until the inflammation subsides.
Even walking or bicycling can be difficult for those suffering from heel pain or foot pain.
Plantar fasciitis affects about one in ten Americans at some point in their lives, and the condition can be stubbornly resistant to treatment. My patients sometimes express frustration at the slow rate of recovery. We counsel patience and remind them that 90 percent of patients improve in less than ten months without surgery.
Non-surgical ways to treat this condition include taping the foot, special splints to stretch the calf muscles, cortisone injections and radiofrequency treatment.
Other treatments include icing the foot and non-steroidal anti-inflammatory drugs such as Ibuprofen. Some patients find that special footwear helps relieve the pain. We may prescribe shoe inserts.
Good footwear is important. Your shoes should support the arch, with slightly raised heels. It’s best to avoid going barefoot.
Plantar Fasciitis and Excersise
Plantar fasciitis often forces people to change their exercise routine, switching to sports or activities that involve less stress on the feet. Any activity that involves pounding on hard pavement should be avoided.
Specific exercises may help.
- One that I like has the patient sit with the affected foot stretched out in front of them. Wrap a towel or a scarf around the bottom of the foot and pull towards you to stretch the plantar fascia. Hold the stretch for 30 seconds. Repeat this exercise three times, stretching as much as possible without pain.
- Another good exercise has the patient sitting in a chair. Swing the injured foot under the chair and press the heel down on the floor. Hold this pose for 30 seconds.
You can also stretch the calf by standing at arm’s length from a wall. Place your hands against the wall with the injured leg closer to the wall and the other leg stretched out behind you. Keeping both heels on the floor, bend the front knee until you feel a stretching in your calf muscle on the injured leg. Count to 30 seconds and release.
These exercises can be performed at work or at home. Try to repeat them several times during the day, always letting pain be your guide.