The Heel Pain Blues
Heel pain can be devastating, causing one to limp and avoid walking and exercise. It is so
common that I see 3-4 people a day with trouble walking due to heel pain. Most people
complain of pain that is worse with first steps in the morning or after rest. It then progresses to
pain that lasts all day long. Symptoms start on the bottom of the heel and can radiate around
the edges of the heel. Women find that a higher heeled shoe reduces symptoms.
Heel pain is not caused by heel spurs. Bone does not hurt. The pain is due microscopic tearing
of the ligament (plantar Fascia) that attaches to the bottom of the heel. As we walk, the arch
flattens and rises with each step causing a pull on the ligament. Lack of arch support causes
tearing, inflammation and pain. This is why symptoms are seen more in the summer when
people are wearing flat sandals, flip flops or walking barefooted.
Treatment varies depending on how severe the symptoms are. I start by dispensing over the
counter arches to my patients with Plantar Fasciitis. This is accompanied by stretching exercise
instructions. If symptoms are not relieved in a few weeks, next steps include increased arch
support, injections (1-2 max.) and physical therapy. The ultimate cure of symptoms is some
type of arch support whether it be OTC or a custom orthotic since this is a mechanical dropping
of the arch and mechanical supporting of the arch is needed. This treatment regime is a simple
way to combat heel pain. My motto is: “No One should live with foot pain”. Let me help you
with yours.