Question: Why does my heel hurt when I first get out of bed in the morning?
fall 2004 – volume 1, issue 1
Brian Cragg responds:
A condition called plantar fasciitis is the most common cause of pain in the bottom of the heel. The plantar fascia is a thin layer of tough tissue supporting the arch of the foot, and repeated microscopic tears of this area causes the pain. People with this condition usually complain of pain under the heel when they first step out of bed in the morning, when they stand up from a seated position, after they have stood on their feet for a long time, and when walking or running. The pain is usually felt in the bottom of the heel and may actually radiate throughout the bottom of the foot towards the toes. Sometimes plantar fasciitis is called heel spurs, but this is not always accurate, since the bony heel spur growth often seen on x-rays may or may not be a factor.
Causes can include:
• Pronated or flat feet
• High arched feet
• Obesity or sudden weight gain
• Use of shoes with poor support
• Occupations with prolonged standing or walking
Treatment Options
The pain associated with this condition can progress quickly, so you should have it treated right away.
One or more of the following treatment options should be started as soon as possible:
• Take it Easy. Rest is the first and most important part of treatment. Every step you take irritates the inflamed plantar fascia. Standing, walking or running should be temporarily avoided.
• Support Yourself. Orthotics are custom-made arch supports that are placed inside your shoes. They are made from a impression of your foot and help to support the arch of your foot.
• Wear the Right Shoes. Supportive jogging shoes with firm mid soles, heel counters and laces help to support the foot.
• Consider Cold Comfort. Place an ice pack on the heel and arch for 15 minutes. This may relieve the pain and inflammation after exercise and work.
• Tape it Up. A chiropodist can apply tape to your foot to help hold up the arch and take pressure off the plantar fascia.
• Employ Other Options. If symptoms persist, treatments such as night splints, ultrasound and laser therapy, anti-inflammatory medication and cortisone injections can be added.
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