One of the most common problems I see in the office is heel pain. Heel pain can be caused by many things. Most people think they have a “heel spur” if they have pain in their heel. The truth is they may have a spur, but, a bone spur rarely causes pain. Most commonly heel pain is caused by plantar fasciitis. However, keep in mind not all heel pain is plantar fasciitis.
The plantar fascia is a ligament that runs from the ball of the foot into the heel bone. It is the tight band of tissue you can feel in your arch when you pull your toes toward you. This tissue, the plantar fascia, becomes inflamed and irritated at its attachment into the heel bone. Every step that is taken causes a straining or pulling of the plantar fascia. This can cause a very painful condition as it makes it hard for the plantar fascia to heal when it is injured.
The three most common descriptions I get from my patients when they have plantar fasciitis are: pain when going from sitting to standing during the day, severe pain in the heel or arch when getting out of bed in the morning- (this may improve with 2-3 minutes of walking and stretching), and pain that gets worse in the bottom of the heel/arch as the day progresses. Remember, foot pain is never normal! Most foot pain can be effectively and easily treated.
Here are the 8 things you must do if you have heel pain.
*Avoid going barefoot. Wear a shoe or slipper around the house. I often recommend Crocs to be worn in the house. Your foot needs support. Walking barefoot in the house, especially if you have hardwood floors or your home is built on a concrete slab foundation, will aggravate an already inflamed plantar fascia.
*Stretch your calf. A tight achilles tendon can cause heel pain. There are several stretching exercises that you can do to decrease tightness and pain.
*Avoid wearing worn out shoes. Often times it is the favorite pair of old shoes that causes plantar fasciitis.
*Try using an insert in the shoe to support your arch. Avoid the flimsy supports you will find at the big box stores or the grocery store. The over the counter supports I recommend are Powersteps or Superfeet. You should not have to pay more than $50 for a good over the counter insert.
*I have never met anyone named Dr. Scholl. It is a big company. They make some great products. Arch supports for plantar fasciitis are not on the great product list. There are fancy machines in Walmart now. Regardless of what they advertise, those machines do NOT give you a “custom orthotic”. Save your money and try a Powerstep or Superfeet device. Avoid being scammed by stores selling “custom orthotics” or special inserts.
*Don’t avoid seeing a podiatrist for foot pain. Would you go to the mall for heart problems? Of course not. Then why do so many people go to a shoe store for foot problems? The clerk there is most likely not a doctor. I hate seeing a patient come in who has spent a lot of money on an insert purchased from a local store. Avoid the advertising scam! Podiatrists have years of training and, in most cases, can quickly diagnose and treat most foot problems.
*Use ice. I recommend my patients use a 16 ounce water bottle. Freeze it. Roll it in the arch. The ice helps decrease inflammation and the motion of the bottle on the arch helps stretch out the plantar fascia. Try this for 5-10 minutes twice a day.
*If you have heel pain, arch pain, or “heel spurs” for longer than 3-4 weeks, go see a podiatrist. Don’t let this become a chronic problem. The sooner heel pain is treated the quicker it will respond. It will go away with the correct treatment.
If you need to see a podiatrist, they may treat you with a cortisone injection, xrays, ultrasound, physical therapy, a night splint, a custom orthotic, other types of braces or supports, shock wave therapy, or even a new procedure called dry needling. Surgery is rarely needed for heel pain. Remember, heel pain is never normal. It can be effectively treated. A podiatrist is the expert when it comes to foot and ankle care.