Medical Edge Newspaper Column

Treating Heel Pain (Plantar Fascilitis)

July 2, 2007
Readers:

For some people, the first step in the morning sends pain shooting into their heel, as if they were stepping on a sharp rock.

According to a recent issue of Mayo Clinic Health Letter, the most likely cause of heel pain is plantar fasciitis (PLAN-tur FASH-e-I-tis). This inflammation of the plantar fascia, the fibrous tissue that runs along the bottom of the foot, may limit one's regular range of motion.

The pain is usually worst in the morning and can be excruciating. Typically, as the foot limbers up, the pain lessens. Plantar fasciitis affects people of all ages. Contributing factors can include wearing high heels or shoes with poor arch support; lifting heavy objects or making sudden increases in weight-bearing activities. Excess body weight also can be a factor.

Giving the plantar fascia a chance to heal will take patience and persistence. With self-care treatments, the condition usually clears up within 24 months. Consider these self-care tips to help reduce pain:

Daily stretches: Stretching increases the flexibility of the plantar fascia, Achilles tendon and calf muscles. Stretches before getting out of bed can reduce pain.

Cooling the heel: Soaking only the heel in cold water may help. Applying a cloth-covered ice or gel pack for 15 minutes, especially after an activity, may reduce pain. A bag of unpopped popcorn kernels, cooled in the freezer and used as an ice pack, also can be effective.

Wearing appropriate shoes: Low- to medium-heel shoes (no more than 1- to 2-inch heels) with good support and shock absorption are best. A variety of shoe inserts such as heel cups, specialized over-the-counter insoles and arch supports can be beneficial, too.

Pain relievers: Nonprescription pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, others) can ease pain and inflammation.

When self-care options aren't enough, a physician can recommend other options such as orthotics, night splints, physical therapy, cortisone injections and other treatments.