Ask an Expert: Plantar Fasciitis

Q: "When I first get out of bed in the morning I can hardly walk because of the pain in my heel. What could this be?"

Answered by Kimberly Shields, D.O., primary care physician at Providence Medical Group-Gateway Family Medicine

While heel pain can be a symptom of a number of conditions, what you may have done is irritated the tissues in the bottom of your feet, called the fascia, resulting in plantar fasciitis (pronounced PLAN-tar fashee-EYE-tiss). You might notice this more the first few steps you take in the morning, particularly if you have just started running for exercise. People who are overweight are more likely to experience this kind of heel pain; however, it can occur in anyone.

Plantar fasciitis is the most common cause of heel pain and is caused by any combination of: a change or increase in activities, lack of arch support (bad or new shoes or going barefoot), being overweight, inadequate flexibility in the calf muscles (not enough exercise can cause this), a sudden injury, using shoes with little cushion on hard floors or ground, and spending too much time on the feet.

Here are some things you can try at home to relieve your pain and calm the inflamed fascia.

Rest:  Take it easy with any activity that you think may have caused the pain or made it worse. Don’t go on long walks, do any running, or stand for too long. As an alternative exercise, try swimming until your heel has recovered.

Ice:  Apply ice to the bottom of the foot after activities and at least three times a day for 20 minutes. You should always put a towel between the ice pack and the skin. An ice pack can be purchased or you can use a frozen bottle of water or a plastic bag with ice cubes in it.

Stretches:  Stretching out the muscles in your calf will take tension off the bottom of your foot. This can be done by dropping your heel off of a step or by otherwise flexing your foot by any method. Do this before getting out of bed every morning, before getting up out of a seated position and at least three times a day.
 
In order to prevent recurrences of plantar fasciitis once your pain has resolved, lose weight if you are overweight, wear shoes with proper arch support and cushioning, and exercise regularly.

There are other treatment options such as taping methods, night splints, injections, massage, and medications that may also help. See your health care provider for more information.

Reviewed October 2013