• Sharp pain often localized to the bottom and/or inside margin of the heel
  • Often worse on arising in the morning and after rest
  • Aggravated by prolonged weight bearing and ambulation
  • May severely limit activities
  • Most common in middle-aged and overweight adults, and athletes
  • Excessive load on the foot from obesity or overuse
  • Excessive flattening of the arch on weight bearing
  • Tight plantar fascia, common in persons with high arched feet
  • Over pronation of the foot (a complex motion including outward rotation of the heel and inward rotation of the ankle).
What you can do
  • Application of ice to the heel area after prolonged activity
  • Wear supportive shoes with a stiff heel counter (the part of the shoe which wraps around the heel) and a good arch. A well made running or walking shoe is a good example.
  • Sometimes a shoe with a moderately high heel will relieve pressure on the fascia
  • Stretching and strengthening exercises will stretch the plantar fascia and strengthen the small intrinsic muscles which stabilize the arch. This should not be attempted when the heel is sore.
  • Over-the-counter anti-inflammatory medications containing ibuprofen or aspirin, when tolerated
What the doctor may do
  • Prescription doses of anti-inflammatory medication
  • Inject powerful anti-inflammatory medication to calm inflammation around the painful area
  • Apply taping to relieve strain on the plantar fascia
  • Administer physical therapy (eg. ultrasound, cold laser)
  • Control foot function with an orthotic
  • Prescribe special splints to help stretch the fascia
  • Surgical release of the plantar fascia and excision of the heel spur (rarely required).
Other causes of heel pain
  • Various types of arthritis
  • Trauma to the heel
  • Inflammation of the tendons around the heel
  • Heel Neuroma (benign tumors of the nerves around the heel)
  • Abnormality in the shape of the heel bone
  • Foreign body in the heel (e.g. splinter)
  • Inflammation of the heel bone (calcaneal) growth plate in children