Mourning Morning Heel Pain?
Stabbing, aching, sharp shooting, feels like a stone bruise…these are some of the descriptions of pain that many people complain of when they have heel pain, especially on their first few steps out of bed in the morning. When people either have mechanical issues with their feet or have added stress to them, they often get symptoms similar to those just mentioned. Plantar fasciitis (planter fash-e-ite-is) is the most common heel pain diagnosis. It is caused by excessive physical stress to the plantar fascia (fasha), which is a strong, wide, fairly thick ligament that stretches from the heel to the ball of the foot. The reason that this pain is often worse on the first few steps out of bed or after any amount of rest is that the fascia tightens when at rest when that rest comes after a physically demanding activity. Then, when weight is placed on the foot it naturally wants to flatten out, but the tight fascia does not want to stretch, so it jerks on the heel bone where it attaches or sometimes along its course through the arch. This causes inflammation and pain. The physically demanding stress can be any or a combination of the following:
-poor foot mechanics
-weight gain
-prolonged stance or walking
-uneven terrain
-poor shoegear/poor support
-new exercise routine
-excessive barefoot walking
If this condition goes undiagnosed or untreated for several months, then the inflamed tissue thickens similar to scar tissue. The vast majority of patients respond very well to conservative treatment with only 3-5% requiring surgical intervention. Treatment begins with determining the actual stress, then it may include: orthotics, cortisone injections, anti-inflammatory medication, education on shoes, splinting, lifestyle changes, and physical therapy. If pain is not adequately controlled with conservative treatment then surgery is usually the next step. Call Westfield Foot and Ankle for an appointment and you will soon be thankful that you did.
