Hubballi Pain And Palliative Care

Are you suffering from heel pain?

Do you feel pain in your ankle or heel first thing in the morning? Is the first step you take in the morning the most painful one? Do you experience heel pain when standing for long durations? If touching the inner side of your foot causes pain, then you are likely suffering from a common heel pain condition called plantar fasciitis. Read on to learn more.

Plantar fasciitis affects approximately one in every 1,000 people worldwide, impacting both men and women, especially those in the working population. Common causes of this pain include standing for prolonged periods, being overweight, running on uneven surfaces or with improper footwear, and engaging in work-related weight-bearing activities while wearing shoes with poor shock absorption. This condition results from repeated irritative trauma to the sole pad of the foot, making it a degenerative disease. Typically, individuals endure plantar fasciitis for six months or more before consulting a primary care physician.

What are the treatment options?

More than 85% of people suffering from this type of heel pain find relief through medications and exercises. Your doctor will first rule out other serious causes of foot pain, such as fractures, Morton’s neuroma, ganglions, or sprains, before initiating treatment.

Treatment options for plantar fasciitis typically include simple measures that can be implemented at home or in the workplace:

• Rest: Avoid prolonged standing, running, and weight-bearing activities.
• Physical Exercise: Perform stretching exercises for the ankle and heel as demonstrated in accompanying diagrams.
• Warm and Ice Therapy: Alternate soaking your feet in warm water for seven days with ice water soaks for seven days.
• Weight Loss: Maintaining a BMI below 25 kg/m² helps preserve the inner arch of foot and prevents the recurrence of pain.
• Use of Night Splints: Night splints can provide rest and relief by immobilizing the sole of the foot.
• Orthotics or Insole Inserts: These support the foot’s arch and can alleviate pain.

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For cases that are refractory to these measures, consulting with your doctor is advisable. Additional treatment options include:

• Pain Relieving Medications: A short course of pain relievers can alleviate acute heel pain.
• Injections: For persistent pain, options like steroid injections, dextrose prolotherapy, and platelet-rich plasma may be considered for both short- and long-term relief.
• Surgery: In stubborn cases, surgery may be performed, albeit with mixed results.

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The key to treating plantar fasciitis is continuous follow-up with your physician and lifestyle modifications. Over the course of a year, microtears and degeneration in the sole can reverse, leading to significant improvement for most patients.

Dr Milon V Mitragotri