Heel Pain: Is It Plantar Fasciitis?

Heel pain

Hello, Director! My mother has to stand for 8 hours at work every day.
She says that recently, after getting up in the morning, her heels hurt so much that she can't get out of bed and can't stand for too long.
Could she be experiencing plantar fasciitis? Thank you!

Yi Fan, 20~29 year old female. Ask Date: 2008/02/17

Dr. Su Hongci reply Rehabilitation

The function of the plantar fascia is to maintain the arch of the foot, allowing it to remain elastic and absorb the impact of ground reaction forces during running or jumping.
The initial symptom of plantar fasciitis is a sudden, severe pain in the heel when getting out of bed in the morning, which can even lead to difficulty walking.
However, after a few minutes of activity, the pain may decrease, but it can reoccur in the afternoon or after excessive activity.
Common causes include overuse, such as being overweight, standing for prolonged periods, or walking too much, as well as abnormal tension in the plantar fascia due to conditions like flat feet, high arches, or shortened Achilles tendons.
These factors can lead to injury of the plantar fascia, resulting in acute or chronic inflammation.
Physical therapy for plantar fasciitis includes conservative treatments such as stretching exercises, ultrasound therapy, ice application, and arch support insoles.
Additionally, regular maintenance is crucial.
Daily care for plantar fasciitis involves eliminating factors that trigger or exacerbate pain, such as reducing standing time, losing weight, stopping running during severe inflammation, and avoiding walking barefoot on hard surfaces.
It is important to allow the feet to rest and to apply ice to alleviate pain and inflammation.
Gentle stretching exercises for the calf muscles and the plantar fascia can be beneficial, along with light massage in these areas to reduce tension in the plantar fascia.
Choosing soft, loose-fitting shoes and using arch support insoles can help minimize irritation.
If recovery is inadequate, a physician may consider administering corticosteroid injections.
Surgery to release the fascia is only considered if all other treatments fail.

Reply Date: 2008/02/17

More Info

Heel pain, especially when it occurs in the morning or after periods of inactivity, is a common symptom that can often be attributed to plantar fasciitis. This condition is characterized by inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of the foot and connects the heel bone to the toes. Given your mother's symptoms of heel pain upon waking and difficulty standing after being on her feet for extended periods, it is quite possible that she is experiencing plantar fasciitis.

Plantar fasciitis typically presents with sharp pain in the heel, particularly noticeable during the first steps in the morning or after sitting for a long time. The pain may decrease with movement but can return after prolonged standing or after getting up from a seated position. This pattern aligns with your mother's experience of pain after standing for long hours at work and upon waking.

Several factors can contribute to the development of plantar fasciitis:
1. Overuse: Standing for long periods, especially on hard surfaces, can put excessive strain on the plantar fascia. Your mother's job requiring her to stand for eight hours daily could be a significant contributing factor.

2. Foot Mechanics: Flat feet, high arches, or an abnormal walking pattern can increase stress on the plantar fascia. If your mother has any of these foot types, it may predispose her to this condition.

3. Weight: Being overweight can add extra stress to the plantar fascia, increasing the risk of inflammation.

4. Age: Plantar fasciitis is more common in middle-aged individuals, although it can occur at any age.

5. Improper Footwear: Shoes that lack proper arch support or cushioning can exacerbate heel pain.

To confirm the diagnosis of plantar fasciitis, it would be advisable for your mother to consult a healthcare professional, such as a podiatrist. The doctor may perform a physical examination and possibly recommend imaging studies, like an X-ray or MRI, to rule out other conditions such as heel spurs or stress fractures.

In terms of treatment, there are several effective strategies for managing plantar fasciitis:
- Rest and Ice: Reducing activity and applying ice to the affected area can help alleviate pain and inflammation.

- Stretching Exercises: Stretching the calf muscles and the plantar fascia can improve flexibility and reduce tension on the heel.

- Orthotics: Custom or over-the-counter arch supports can provide additional support and cushioning, helping to distribute pressure more evenly across the foot.

- Physical Therapy: A physical therapist can design a personalized exercise program to strengthen the muscles of the foot and improve flexibility.

- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.

- Injections: In some cases, corticosteroid injections may be recommended to provide relief from severe pain.

- Surgery: This is generally considered a last resort if conservative treatments fail after several months.

Encouraging your mother to wear supportive footwear and to take breaks while standing can also help manage her symptoms. If her pain persists or worsens, seeking medical attention is crucial to prevent further complications and to explore more advanced treatment options.

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