If your first step of the morning causes a sharp, shooting pain in your heel, it may be plantar fasciitis. This is one of the most common causes of heel pain.
Plantar fasciitis occurs when the ligament (the plantar fascia) that runs across the bottom of your foot, connecting your heel bone to your toes, becomes inflamed and pulls when you step.
Typically, after you stand and walk, your calf muscles warm up and the pain goes away. It might return after long periods of standing or sitting.
The condition is most common in women ages 40 to 60 and usually begins gradually in one foot.
One cause of plantar fasciitis is increased or high demand activity such as running or dancing.
You are more susceptible if you are flat footed, have a high arch or are obese.
Often plantar fasciitis results from wearing flip flops or flat shoes with no arch support. Even high heeled shoes can promote plantar fasciitis, by contracting and shortening the Achilles tendon.
When it comes to fashion shoes, moderation is the key.
On a day when you're wearing heels, flats or flip flops, find time to wear supportive shoes, such as a good pair of sneakers or other firm soled shoes with arch support. As a rule, a flat shoe with a sole that you can bend in half does not provide good support.
Untreated, plantar fasciitis can develop into chronic heel pain and can even affect your foot, knee, hip or back if your gait or posture changes to accommodate the pain.
If you suspect that you have plantar fasciitis apply ice to your heel in 20 minute increments several times per day, stretch your calf muscles and heel, and wear only supportive shoes. If this eliminates your pain, continue with the stretches and supportive shoes to prevent a recurrence.
If the pain doesn't resolve within a week, a heel and ankle specialist can rule out a more serious condition such as a tear in the Achilles tendon, a fracture of the heel bone or stress fracture.
Occasionally the pain could be caused by bone tumors or nerve entrapment near the area.
The specialist will ask you to describe your pain and any triggers. He will also look for areas of tenderness and try to pinpoint your pain. Sometimes an imaging test such as an X-ray or MRI will help rule out other causes of heel pain.
Heel pain caused by plantar fasciitis is managed with over the counter anti-inflammatory medications, ice, rest, stretching and proper foot wear. Sometimes orthotics are used to compensate for foot structure issues that aggravate the problem.
Physical therapy can help you learn stretches to manage your condition.
In rare cases, cortisone injections or surgical treatment may be required.
You can prevent plantar fasciitis by wearing supportive shoes and stretching your calves and heels regularly.
While heel pain from plantar fasciitis is not dangerous to you, it is easiest to treat in its earliest stages. So don't ignore the symptoms, and seek treatment after one week if the pain doesn't go away with rest, ice, stretching and supportive footwear.
Ritter, a graduate of Temple University School of Podiatric Medicine, is practicing at Susquehanna Health Foot and Ankle Specialty Care on the Divine Providence Hospital campus.