Back of the heel pain in the morning: The request could not be satisfied
Heel Pain In The Morning: Help Plantar Fasciitis
Do the first few steps out of bed each morning cause you to wince in pain? Plantar fasciitis might be the cause.
Plantar fasciitis is one of the most common causes of heel pain, impacting more than 2 million people each year. This condition in the heel of your foot is caused by inflammation and swelling of the plantar fascia, a ligament that extends from the heel to the toes on the bottom of the foot. The inflammation and swelling can lead to a feeling of sharp pain in the foot, toward the heel, or a feeling of tenderness throughout the underside of the foot, especially at the ball of the foot.
“The plantar fascia is a thick band of tissue that forms part of your soft arch in your foot,” explained Adam Lyon, MD, a foot and ankle surgeon with Franciscan Physician Network Orthopedic Specialists Indianapolis. “Chronic overuse or repetitive tension on the plantar fascia causes pain at the its origin on the plantar calcaneus (heel bone). ”
Why Does Plantar Fasciitis Hurt In The Morning?
“Plantar fasciitis most commonly occurs with the first few steps in the morning or after sitting for a long time and toward the end of the day from prolonged standing,” Dr. Lyon said. “Morning pain is from the sudden tension of the plantar fascia as it gets stretched after shortening overnight.”
What Is The Main Cause Of Plantar Fasciitis?
“The primary cause of plantar fasciitis is calf or Achilles tightness,” Dr. Lyon said. “Other risk factors include repetitive impact activities and obesity.”
This ligament in the heel of the foot can become inflamed after wearing non-supportive footwear on hard, flat surfaces for a prolonged period. Also, being overweight or having a very high arched foot or a flat foot can irritate the ligament.
Plantar fasciitis is the most common heel injury in athletes, especially runners, because jumping and repeated pushing off can hurt the plantar fascia.
Are Plantar Fasciitis And Heel Spurs The Same?
A bone spur is a small, abnormal bone growth that can cause pain if they rub on a nerve or other tissue. A heel spur may be located on the underside of the heel bone where it attaches to the plantar fascia.
“Heel spurs are frequently seen on X-rays in those with long-standing plantar fasciitis,” Dr. Lyon said. “Heel spurs do not cause the pain, rather they are sign of long-standing tension on the plantar fascia.”
Treatment options for heel spurs are similar to treatment as for plantar fasciitis. These include home care including rest, ice, anti-inflammatory medicine, stretching and correct footwear or shoe inserts.
More serious heel spurs may require corticosteroid shots (injections) under a physician’s guidance or surgery.
Can I Treat Plantar Fasciitis At Home?
Home treatment of plantar fasciitis includes stretching exercises to stretch out the calf and plantar fascia, massage therapy, losing weight as well as avoidance of walking barefoot. Pain relievers such as ibuprofen and naproxen also can ease the pain and inflammation.
Icing the heel is important, as well as rest and elevating the foot.
“The most effective treatment for plantar fasciitis includes calf and Achilles stretching, plantar fascia stretching, and a night splint or a night sock,” Dr. Lyon said. Heel pain is usually treated conservatively without surgery.
What Are Good Exercises With Plantar Fasciitis?
While plantar fasciitis may make it harder to do your regular activities, it is important to not change the natural way you walk, as this can lead to other joint, foot or back problems.
Most people with plantar fasciitis recover without much treatment in a few months.
“Non-impact exercises such as swimming, walking, or biking are well tolerated in those with plantar fasciitis,” Dr. Lyon said.
When Do I Need To See A Doctor For Heel Pain?
If home treatments for heel pain and plantar fasciitis fail, a visit to your doctor may be in order. Your doctor may suggest a steroid injection, physical therapy, wearing a custom orthotic splint, or ASTYM therapy or surgery to separate the plantar fascia from the heel bone.
“Should conservative treatment fail and the symptoms are severe enough, surgery may be needed,” Dr. Lyon said. “My preferred surgical treatment is a gastrocnemius recession, which is to release and effectively lengthening one of the calf muscles to decrease the calf tightness and relieve the tension of the plantar fascia.”
What Happens If Plantar Fasciitis Is Left Untreated?
Not treating plantar fasciitis may result in chronic heel pain that makes it harder to do your regular activities. It is important to not change the natural way you walk, trying to prevent pain, since this may cause foot, knee, hip or back problems.
Is It Normal to Wake Up with Heel Pain?
Here’s a scenario that plays out across millions of American bedrooms every morning, usually sometime between 5 and 7 a.m. Maybe you’re familiar with it.
After a hopefully long, hopefully restful slumber, you sit up, throw off the covers, turn your feet so they’re dangling just a few inches off the floor, then …
Wince. You know what’s coming.
As soon as you put that foot on the ground and load a bit of weight onto it, a sharp pain in your heel inevitably follows. And it may take several minutes of hobbling around as you try to get dressed or cook breakfast before you finally start to feel normal again.
What in the world is going on? This can’t be normal, right?
What Is It?
Although we’d need to perform a complete evaluation before we can confirm any diagnosis, what we’ve just described is the classic symptom of a condition known as plantar fasciitis.
All along the bottom of your foot—from the base of your toes to the heels bone—you have a thick, fibrous band of tissue known as the plantar fascia. Its main function is to support the arch, and when things are going well it does this without issue.
But if the plantar fascia gets overstretched, inflamed, or torn, it can become quite painful. That pain tends to be concentrated right beneath the heel, where it connects to the heel bone.
Why Is the Pain So Bad in the Morning?
The obvious question, of course, is why heel pain should be worst in the early morning and not just all the time, or maybe during activity. Essentially, it has to do with how the plantar fascia responds to cycles of loadbearing and rest.
At nighttime, the plantar fascia rests and contracts, as do your calf muscles. This also can happen while you’re sitting at a desk all day, watching a move—any situation where you aren’t putting any weight on your feet for an extended period of time.
When you stand up again, all of a sudden the injured, contracted fascia has to deal with the full force of your body weight once again, and it just isn’t prepared to do so! Your injury is immediately re-aggravated, and it usually takes a couple of minutes for the fascia to loosen up to the point where the pain recedes to a dull ache.
Is This Really Normal?
It’s important to make a distinction here between something that is common versus something that is normal.
Plantar fasciitis, and its associated morning heel pain, is certainly very common. In fact, podiatrists across the United States treat more than 1 million cases of the condition each year—and that does not include potentially millions more who do not seek treatment.
But that does not make it normal—not even close! Morning heel pain isn’t just something that inevitably happens when you get older, or work certain jobs, or live a certain lifestyle. Heel pain is abnormal, and if you have it, you need to get help for it. Otherwise, it’s very likely that your pain will only become more frequent and more severe as time goes on.
What Can I Do About It?
Here’s a bit of good news.
Even if you’ve been suffering from plantar fasciitis on and off for months or years, there is an excellent probability that, with conservative treatment options from Capital Podiatry Associates, you will be able to get rid of your morning heel pain for good.
That’s right—surgery is almost never required. Maybe 1 out of every 20 cases will reach that point. The other 19 times, we can help our patients clear up their plantar fasciitis without making a single incision.
But to do that, we first need to take a look at your feet and have a good conversation with you about your symptoms and your lifestyle. Plantar fasciitis can spring from several possible root causes, including faulty biomechanics, poor shoes, and your training or exercise routine. Figuring out which of these factors are responsible for your plantar fasciitis is how we personalize a treatment plan that will meet your needs most effectively.
That being said, most cases of plantar fasciitis respond well to very simple traditional remedies, including switching shoes, physical therapy, and wearing night splints. Theses splint keep your plantar fascia elongated while you sleep, so they don’t have to painfully stretch out again when you get up.
And if those simple treatments aren’t quite sufficient for a tougher case of heel pain, our office also provides much more advanced options, including custom orthotics and state-of-the-art MLS laser therapy for pain.
Take Your Mornings Back
You don’t have to dread the first step out of bed any longer.
For a thorough evaluation and treatment options that will actually work, contact Capital Podiatry Associates in Alexandria, VA today. You can request an appointment online, or give us a call directly at (703) 560-3773.
Why Do My Heels Hurt in the Morning?
It’s a story we’ve heard over and over (and over) again.
We ask our patient to describe their pain to us. What are your symptoms like? And we get a variation on this story.
“Well, doctor, in the morning I cringe just thinking about putting my foot down on the floor after getting out of bed. It hurts so bad!”
“Any other times?” we ask.
“Well, now that you mention it, I went to see that new superhero movie last week and my heels hurt so bad when I finally got up out of my seat.”
“Where is the pain located most of the time?”
“The bottom of my foot. Right under the heel. ”
Now, asking a few questions isn’t the same thing as making a full examination. And since a lot of different types of injuries can cause heel pain, we’ll take our time and be careful about our diagnosis.
But when we hear stories like this, the odds are very high that our patient has a condition called plantar fasciitis. Although several different symptoms are possible, that “early morning” stabbing heel pain is its most common and distinguishing feature.
Do My Heels Hurt in the Morning?
Let’s assume your diagnosis is, in fact, plantar fasciitis. Here’s what’s going on.
In order to do this properly, we’re going to have to start from the beginning. Bear with us.
The Ballad of the Plantar Fascia
Basically, at the very bottom of each foot there is a long, tough, flexible band of connective tissue called the plantar fascia. You can think of this is being like a ligament or tendon in terms of its function or composition. In fact, all three types of tissues are primarily made from collagen and very similar to one another, with the main difference being their primary anatomical function:
- Tendons connect muscles to bones.
- Ligaments connect bones to other bones.
- Fascia surround muscles, organs, and other structures to separate them from the skin, attach them to a wide area of the body that they need to act upon, and provide support and stability.
In particular, the plantar fascia—which stretches all the way from the bases of your toes to the front of your heel—has a pretty complicated and tough job. This singular band of tissue has a huge role to play in supporting your arch, evenly spreading the weight of your steps over as much time and area as possible, and even propelling you forward.
It flexes like a bowstring, dampening and storing energy when bearing weight. This, ideally, prevents those impact forces from being too stressful or causing too much damage to any one particular muscle, bone, or part of the foot. Then, when you push off, that stored energy gets released like a spring, making your locomotion more efficient.
Pretty neat, huh? We think so.
But here’s the problem. Your plantar fascia is not invincible. And if it gets overstretched and overstressed without enough time to repair itself, it starts to break down, leading to pain and inflammation.
(More information about the most common underlying causes of this breakdown can be found later in this blog, so stay with us!)
The most common location for this pain and inflammation just so happens to be at the underside of the heel, right where the plantar fascia connects with the heel bone.
But Why Does It Hurt in the Morning
So let’s return to the original question.
If you’ve got a painful, broken down plantar fascia, shouldn’t it just hurt all the time—whenever you’re using it? What’s with the spike in discomfort when getting up after a break?
Essentially, the answer has to do with what’s happening to the tissue when you’re not bearing weight. When you’re sleeping or taking a breather, the inflamed plantar fascia contracts and shortens slightly. Think of it like a muscle or joint that feels a little stiff until you’ve had a chance to warm up a bit.
Unfortunately, once you put weight on that foot again, the sudden force load comes as something of a shock to your plantar fascia. That initial re-stretching and re-aggravation of the damaged tissue can be quite painful. Give it a few minutes, though, and your discomfort will start to recede (though probably not totally go away).
Incidentally, this is why night splints are commonly recommended for plantar fasciitis sufferers. The splints keep the fascia in an elongated position during the night, so that its better prepared to handle that initial morning shock.
How Did I Get Here?
We touched on it briefly above, but let’s get into more specifics.
The “big picture” cause of most cases of plantar fasciitis is overuse. Simply put, your plantar fascia has to bear too much weight too often over too long a time without enough of a chance to rest and recover. Sooner or later, it’s going to break down.
But what specific activities or choices can lead to that kind of breakdown? There are lots of possibilities, but here are some of the most common risk factors:
- Tough jobs. Tons of us spend most of the day on our feet. If you work in healthcare, construction, education, logistics, or any of a couple dozen other fields, you know what we’re talking about. It’s even worse if the surfaces underfoot tend to be cement, tile, or other hard and flat materials without much give.
- Bad shoes. The right pair of shoes can really make or break it for your heel pain. A supportive pair with good cushioning and support will give your arch (and by extension plantar fascia) a little extra assist with every step you take throughout the day. Bad shoes leave the plantar fascia to fend for itself—with sometimes disastrous results.
- Active hobbies. No, we’re not saying you need to give up running or playing basketball. But it’s undeniable that certain activities—especially of the “running and jumping” variety—can seriously stress out your heels. If you like being active, wearing the right shoes and following a sensible training protocol becomes even more important.
- Foot structure. Unfortunately, for some of us genetic inheritance is on the list of culprits. If you were born with—or subsequently developed—an inefficient foot structure such as a flat foot, high arch, or gait abnormality, your basic way of walking might be putting more strain than usual on your plantar fascia.
- It’s no secret that obesity has become more prevalent in our society in the last few decades—and our home state of Oklahoma has the third worst adult obesity rate in the nation, at more than 36 percent. Since the impact force on your plantar fascia can actually be equivalent to a couple of times your own body weight, carrying a few extra points can really put a lot of excess strain on the plantar fascia.
Now, as you might imagine, the fundamental cause of your plantar fasciitis makes a major difference in terms of how best to treat and prevent it.
For one person, for example, the best remedy might include a new a pair of shoes and a squishy mat at their workstation. For another, custom orthotics are going to be a major piece of the puzzle. Athletes and workers, meanwhile, might especially be interested in some of our advanced therapies, such as shockwave, to accelerate the tissue healing process.
When you hobble into the Foot & Ankle Center of Oklahoma, we’ll be sure to get to the bottom of what’s troubling you and leading to your morning heel pain. That way, we can offer you the absolute best possible treatment plan—one that not only perfectly addresses the cause of your plantar fasciitis, but also makes sense within the context of your lifestyle.
So stop suffering from morning heel pain! The team at Foot & Ankle Center of Oklahoma provides effective treatments for people just like you literally every day. You can enjoy that relief, too.
To schedule an appointment with us in Oklahoma City—or at our new clinic in Moore!—just give us a call at (405) 418-2676. You can also request an appointment online.
Runners’ Morning Heel Pain: Understand It and Heal It
A common complaint of runners is heel pain. Many medical diagnoses can be grouped under the symptom of heel pain. These diagnoses include Achilles tendonitis, Achilles tendonosis, plantar fasciitis, and flexor tendonitis. As a physical therapist that specializes in treating running injuries, a frequent question I ask my patients is, “ How intense is your heel pain when you stand and take your first steps in the morning?”
Why are the symptoms so severe in the morning? Why is it that the runner can frequently “walk it off” and continue with training only to experience the same (or worse) symptoms the next day? Treating this common and complicated condition requires that runners understand the physiology of the healing process.
The tendons and fascia that surround the calcaneus (heel bone) are primarily composed of fibrous, rope-like cells called collagen. These tissues are in a daily flux of breaking down and rebuilding. This tissue turnover is especially active in runners because of the increased stresses they put on their bodies. The Achilles tendon, plantar fascia, and toe flexor musculature must withstand huge stresses because of their role in decelerating the impact of up to 6-10 times our body weight during running. At the cellular level, the decelerating forces tear collagen fibers. One of the most amazing things about this process is that the tissues can repair themselves. And, if we don’t overstress our tissues (by running too far, too fast, or both), our tendons and tissues can come back stronger. That is how we accomplish those PR’s.
However, if runners do not allow their tissues to recover properly, injuries occur. Runners can experience acute or chronic injuries. The following explanation and advice will focus on runners with chronic heel pain. With a chronically injured tissue, the body produces collagen in an excessive and disorganized manner. A good analogy is that instead of the collagen fibers’ normal alignment appearing as uncooked spaghetti noodles lined up in a box, the traumatized and damaged fibers appear as cooked spaghetti in the bottom of the pot. This process is called collagen cross-linking.
Much of our healing occurs at night while we sleep. Before maturation, collagen fibers are quite delicate and malleable. During sleep, a pointed foot position (due to the weight of our foot and the bed covers) causes the collagen fibers of the foot and ankle to shorten. Upon standing and stepping out of bed in the morning, the shortened collagen fibers have not had adequate time to reach their full strength. That sharp pain that occurs with weight bearing is the shortened collagen fibers tearing apart. And so the process starts again – every morning.
I cannot stress enough the importance of proper positioning of tendons during bouts of prolonged immobilization, such as sleeping. If collagen fibers are allowed to shorten and undergo cross-linking, runners’ tissues will not adequately support their body weight without re-tearing. Placing a light stretch on healing tissues influences the length and alignment of the new collagen before it reaches the maturation phase and extensive cross-linking occurs. A gentle, sustained stretch throughout the night followed by a gentle manual stretch is vital in preparing the tissues for weight bearing. After the stretch, it is important to protect the tissues with proper shoe wear. Shoes or sandals must be right next to the bed and convenient to put on first thing.
Sit with knee straight and towel looped around left foot. Gently pull on towel until stretch is felt in calf. Hold 30 seconds. Repeat 1 time per set. Do this before you get out of bed.
I have had great results with my running patients if they follow three pieces of advice.
- Wear a splint that stretches the heel and plantar foot structures (night splint, Strassberg sock)
- Very gently stretch the tissues before getting out of bed
- Slip into a supportive shoe or sandal for your first steps. If you have Achilles problems, a higher heeled shoe is effective. Plantar fasciitis may respond better to a softer sandal with arch support.
[Note: some severe cases of Achilles tendonitis/tendinosis may not tolerate a night splint or stretching]
Hopefully this information will allow you to understand and treat your pain. If you continue to be challenged while returning to running, make an appointment with a physical therapist that specializes in treating runners in your area.
Keep on Running!
This article can be seen in NW Runner, July 2010.
What Is Plantar Fasciitis? Symptoms, Causes, Diagnosis, Treatment, and Prevention
Most cases of plantar fasciitis can be treated with rest and applying ice. Over-the-counter pain relievers like ibuprofen (Advil, Motrin B) and Aleve (naproxen) can help reduce some of the pain and inflammation associated with the condition. (7) Orthotics, or shoe inserts that provide support and relieve pressure on the foot, can also alleviate pain in the short term. (13)
Stretching and strengthening exercises can also speed recovery and help avoid other complications, such as tightness or weakness of other foot muscles. A physical therapist can show you effective stretches to loosen the plantar fascia, as well as exercises to strengthen your lower-leg muscles. (7)
Stretches for Plantar Fasciitis
One of the best stretches you can do to facilitate recovery and help prevent plantar fasciitis from coming back is a standing calf stretch with your toes on the wall. “It’s almost like you’re stretching [the plantar fascia] from both ends,” Steege says.
To do it, prop your toes against a wall so your legs are straight, and step one foot back. Keeping both legs straight, gently push your body toward the wall so you feel a stretch in your front foot and calf. Hold for 30 to 60 seconds. Switch sides, performing two or three times per side.
Another effective calf stretch is known as the runner’s stretch, according to Quirolgico. To do it, begin standing in front of a wall at arm’s length from it with your feet hip-width apart. Place both hands flat against the wall and bend one knee. Step the other foot back so your leg is straight, heel flat on the ground. Keep both feet pointed forward and gently press into the wall until you feel a stretch in your back calf and heel. Hold for 30 to 60 seconds and perform two or three times per side.
Stretch out your calves both before and after exercise.
Plantar fasciitis is usually more painful after you’ve been immobile for a period of time (as when sleeping or sitting at your desk). To ease pain and loosen up the plantar fascia, roll your foot over a lacrosse, tennis, or small massage ball for a few minutes before you stand up. “You’re giving input to those tissues to try and calm them down before you start moving,” Steege says.
You can also roll your foot over a frozen water bottle to ice and massage the plantar fascia at the same time. (1) “Having that icing component helps decrease inflammation locally in some patients,” Quirolgico says. Ice baths and applying ice via an ice pack are also recommended to help manage pain. (7)
Other Treatment Options for Plantar Fasciitis
Another option to help you recover is to wear a dorsal night splint. Designed for nighttime use, a dorsal night splint keeps your ankle propped up, stretching out the plantar fascia while you sleep. “But some patients don’t like wearing anything on their feet at night, so they end up taking it off,” Quirolgico says. For those patients, she recommends wearing the splint for a couple of hours in the evening. “It functions in the same way as doing calf stretches,” she says.
Nutrition may play a tangential role in triggering and managing plantar fasciitis.
A 2014 case report noted a patient whose plantar fasciitis went into remission when she maintained a gluten-free diet, but it did not establish a direct cause-and-effect relationship. (14) Dietary intake of certain types of foods such as dairy, sugar, and trans fatty acids may contribute to inflammatory conditions like plantar fasciitis, but this link has not been clearly established in the medical literature.
Obesity is a known risk factor for plantar fasciitis, and research shows that people who are obese are more likely to experience recurring plantar fasciitis. (15) It is unclear if diet is a factor, but losing weight has many health benefits and at a minimum would reduce the pressure on the heels.
Surgery Options for Plantar Fasciitis
If the pain hasn’t resolved after several months of limiting activity, increasing stretching, and other behavior changes, your doctor may recommend more invasive procedures like surgery, steroid injections, extracorporeal shockwave therapy, or ultrasonic tissue repair. (7)
Alternative and Complementary Therapy Options for Plantar Fasciitis
In addition to conventional care methods, acupuncture, a treatment modality commonly used in traditional Chinese medicine, may also be a safe and effective treatment option for plantar fasciitis. (16)
Acupuncture is often used to treat pain and involves the insertion of thin needles through the skin at specific points in the body to redirect the flow of energy. The evidence suggests that stimulating the nerves, muscles, and connective tissue in specific areas helps boost your body’s natural pain-relieving abilities. (17,18)
According to one review of eight studies published in the journal Acupuncture in Medicine in 2018, acupuncture was shown to be an effective treatment for heel pain and function in people with plantar fasciitis and is comparable to conventional interventions like stretching, night splints, or dexamethasone (an anti-inflammatory medication). (16)
Another review, published in 2017 in the Singapore Medical Journal, found that acupuncture led to a significant reduction in plantar fasciitis pain during four to eight weeks of therapy, which suggests that it may be effective for short-term pain management. More research is needed to determine if acupuncture is effective for long-term pain management. (19)
Acupuncture is generally considered to be safe, so long as the treatment is performed by a qualified practitioner. Most states require a license, certification, or registration to practice acupuncture. (17)
“Acupuncture is low risk and many patients get pain relief from it,” Quirolgico says. However, some patients don’t respond to acupuncture. “In that case I tell patients not to continue if it’s not helping them.”
Learn More About Treatment for Plantar Fasciitis: Medication, Surgery Options, and More
Causes, Symptoms, Diagnosis & Treatment
What is heel pain?
Heel pain is a common foot and ankle problem. Pain may occur underneath the heel or behind it. Many conditions can cause pain in the heels, including:
- Plantar fasciitis.
- Achilles or flexor tendonitis/tendonosis.
- Bone spurs.
- Sever’s disease (mostly in children 8-14 years old).
- Stress fractures.
- Inflamed tendons.
It’s important to have a medical evaluation to help you determine the exact cause of your heel pain so that the proper treatment regimen can begin.
Heel pain can make it difficult to walk and participate in daily activities. Most painful heel conditions improve with nonsurgical treatments, but your body needs time to recover.
How common is heel pain?
More than 2 million Americans experience heel pain every year. The problem affects people of all ages and genders.
Where does heel pain develop?
You might experience pain, soreness or tenderness anywhere in the heel. You typically feel heel pain:
- Behind the heel.
- Beneath the heel.
- Within the heel bone itself.
What causes pain behind the heel?
Several problems can cause pain to develop in the back of the heel:
- Achilles tendinitis: The Achilles tendon is a fibrous tissue that connects the calf muscle to the heel bone. It’s the body’s longest and strongest tendon. Runners and basketball players are more prone to Achilles tendinitis. This overuse injury inflames the tendon. Tendonitis causes pain, swelling and stiffness in the back of the heel.
- Bursitis: Bursitis occurs when fluid-filled sacs called bursae (plural of bursa) swell. These sacs cushion joints, allowing for fluid movement. You may have a tender, bruise-like feeling in the back of the heel. Bursitis typically occurs after you spend a lot of time on your feet.
- Haglund’s deformity: Chronic inflammation and irritation can cause an enlarged bony bump (called a pump bump) to form in the back of the heel. Shoes with higher heels, such as pumps, can make the bump and pain worse.
- Sever’s disease (calcaneal apophysitis): Sever’s disease is a frequent cause of heel pain in active children between 8 and 14. Kids who participate in activities that require a lot of running and jumping are more prone to this problem. The increased athletic activity irritates the growth plate in the back of the heel.
What causes pain beneath the heel?
Problems that cause pain underneath the heel include:
- Bone bruise (contusion): Stepping on a hard, sharp object can bruise the fat padding underneath the heel. You might not see discoloration, but your heel will feel tender when you walk. A stress fracture, as well as Sever’s disease, may cause pain all along the back of the heel on the bottom, side and back of the heel.
- Plantar fasciitis: Plantar fasciitis is by far the leading cause of heel pain. It occurs when the fascia, connective tissue that runs along the bottom (plantar surface) of the foot, tears or stretches. People who run and jump a lot are more likely to develop this painful condition. Treadmills and hard surfaces (such as concrete) for exercise or work are common irritants.
- Heel spurs: Chronic plantar fasciitis can cause a bony growth (heel spur) to form on the heel bone. Heel spurs aren’t usually painful, although some people have pain.
What are the risk factors for heel pain?
Anything that puts a lot of pressure and strain on your foot can cause heel pain. The way you walk (foot mechanics) and your foot’s shape (foot structure) are also factors.
You may be more likely to develop heel pain if you:
- Are overweight (have obesity).
- Have foot and ankle arthritis, flat feet or high foot arches.
- Run or jump a lot in sports or for exercise.
- Spend a lot of time standing, especially on concrete floors.
- Wear improperly fitted shoes without arch support and/or cushion.
What are the symptoms of heel pain?
Heel pain symptoms vary depending on the cause. In addition to pain, you may experience:
- Bony growth on the heel.
- Discoloration (bruising or redness).
- Pain after standing from a resting/sitting position.
How is heel pain diagnosed?
Your healthcare provider will assess your symptoms and perform a physical exam. You may also get X-rays to check for arthritis, bone fractures, bone alignment and joint damage.
Rarely, you may need an MRI or ultrasound. These can show soft tissue problems which X-rays don’t reveal.
What are the complications of heel pain?
Heel pain can interfere with your ability to get around, work, exercise and complete daily tasks. When it hurts to move, you can become sedentary. An inactive lifestyle can lead to weight gain. You may also become depressed because you can’t do the things you love.
Untreated Achilles tendonitis can cause the tendon to break down (tendinosis). In time, the Achilles tendon can tear or rupture. This problem may require surgery.
How is heel pain managed or treated?
Most problems that cause heel pain get better over time with nonsurgical treatments. Therapies focus on easing pain and inflammation, improving foot flexibility and minimizing stress and strain on the heel. These treatments include:
- Injections: Steroid injections can ease pain and swelling. Steroid injections should rarely, if ever, be given for a tendon problem but may certainly help for plantar fasciitis and bursitis.
- Orthotic devices: Over-the-counter or custom-made shoe inserts (orthotics) can take pressure off the heel. Some people find relief by wearing a splint at night, especially if they get morning pain. A walking boot may be necessary for more severe symptoms. You may also need to switch to more supportive shoes for everyday wear and exercise.
- Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) combined with ice packs ease pain and swelling.
- Physical therapy: Massage, physical therapy and ultrasound therapy can break up soft tissue adhesions. These treatments may reduce pain and inflammation.
- Stretching exercises: Your healthcare provider can show you how to do heel stretching exercises for tight tendons and muscles.
- Taping: You can use athletic or medical tape to support the foot arch or heel.
It’s rare to need surgery to treat most causes of heel pain.
How can I prevent heel pain?
To prevent heel pain or keep pain from returning, it’s important to keep your foot and heel tendons flexible. You should stretch regularly and wear properly fitted, supportive shoes. Runners are especially prone to heel pain. You can prevent running injuries by covering fewer miles and running on softer surfaces.
What is the prognosis (outlook) for people who have heel pain?
Heel pain typically goes away with nonsurgical treatments, but recovery takes time. You need to be patient and give your body time to mend. If you return to your usual activities too quickly, it can set back your recovery. In rare situations, you may need surgery.
When should I call the doctor?
You should call your healthcare provider if you experience:
- Pain that doesn’t improve in a few weeks with rest or pain relievers.
- Pain that makes walking or movement difficult.
- Severe foot or heel swelling, inflammation or stiffness.
What questions should I ask my doctor?
You may want to ask your healthcare provider:
- What is causing my heel pain?
- What is the best treatment for me?
- What can I do to lower the risk of getting heel pain again?
- What types of symptoms need more urgent evaluation?
A note from Cleveland Clinic
Heel pain often improves over time with nonsurgical treatments. Your healthcare provider can determine what’s causing the pain. Your provider can also show you stretching exercises and recommend orthotics and other methods if needed. Many people try to ignore heel pain and continue with activities that make the problem worse. But it’s essential to give your body time to recover. Otherwise, you may develop chronic heel pain that sidelines you for an extended time. The longer you have heel pain the harder it is to effectively treat, so it’s important to get evaluated.
Why is my heel sore when I get out of bed? What can I do?
There are a number of conditions that cause pain on the bottom of your heel. The most common cause is plantar fasciitis, which affects approximately 1 in 10 people.
The plantar fascia is a ligament-like structure that runs from the bottom of the heel to the ball of the foot, and helps to support the arch.
Plantar fasciitis is characterised by a sharp pain when first getting out of bed in the morning, which reduces with walking. However, the pain may return at the end of the day, and be just as painful as the morning pain.
Risk factors for getting plantar fasciitis include being overweight, increased time spent standing and a decreased ankle joint range of motion. These risk factors all place extra stress on the plantar heel, resulting in pain. Therefore, addressing these risks are a key part of successful management.
There are a variety of treatments used for plantar fasciitis, however there is no agreement on which treatments are most effective.
Simple heel pain self-care treatments include:
- reducing weight (ideally a BMI below 30)
- reducing activity levels (e.g. amount of running) or time spent standing
- wearing supportive cushioned footwear (e.g. runners)
- performing calf and plantar fascia stretches before standing after a period of rest
Straight knee calf stretch
Bent knee calf stretch
Plantar fascia stretch
If these treatment fail, there are a variety of other more complex and expensive treatment options. Two commonly provided treatments are foot orthoses (shoe insoles) and corticosteroid injections. Although these treatments are common, it is not known which treatment is more effective.
A new randomised trial (the SOOTHE Heel Pain Trial) will compare these interventions, and is looking for participants with plantar fasciitis.
For more information about participating in the trial please see the website www. heelpaintrial.com or contact Glen Whittaker on 9479 5785 or [email protected]
Reasons | Systemic Diseases | Spine Problems | Treatment at Doctor Ost |
If a pebble gets into the shoe, we shake it out and move on. But what if a “pebble” or “carnation” is stuck inside, and the source of pain is right in the heel, making each step torture.
Do not tolerate heel pain, get a consultation from an experienced orthopedist or neurologist at the Doctor Ost MC. Remember! We are ready to relieve even severe pain in the heel in just one visit.
The cause of heel pain is a heel spur disease, or fasciitis. The disease does not go away on its own, you always need to go to the doctor for help. The professional must establish the root cause of heel pain and prescribe effective treatment.
WHY DOES THE HEEL HURT?
The cause of pain can be different, but, as a rule, it is a pathology of the musculoskeletal system. The federal network of medical centers “Doctor Ost” specializes in the diagnosis and treatment of problems of the musculoskeletal system.According to the patient’s story and after examination, the orthopedic traumatologist can suggest various causes of pain in the heels and legs and then make diagnoses:
- PLANTAR FASCIET
A spur on the sole and acute pain in the heel are the most common causes, diagnosed in half of the patients who applied. In many respects, because the pain with this diagnosis is so intolerable and interferes with walking that the patient understands that one cannot do without a doctor.
Severe heel pain occurs upon waking and accompanies each step in the morning.After some time, the “nail” feels a little dull. However, the patient can no longer lead his usual way of life and is unable to think about anything except how to relieve pain in the left or right heel.
The main thing that distinguishes the heel spur is the presence of a well-defined soreness in the middle of the heel on palpation. There is an osteophyte – that same “spur”, a growth in the place where the tendon joins the bone.
This is an inflammation of the joints. If the lower legs and heels are involved in the pathological process, it is important to start treatment of pain with the diagnosis of the Achilles tendon in order to exclude bursitis.The Achilles tendon attaches the muscles of the back of the calf to the heel. According to statistics, athletes suffer from bursitis more often than others. The main reason is the regular overstrain of the gastrocnemius muscle for a long time, as well as a sharp load, the use of corticosteroids and anabolic steroids. Small injuries – cracks and tears in the tendon – become a source of inflammation, pain, radiating, first of all, to the heels.
Patients also complain of symptoms:
- swelling around the damaged tendon;
- tension in the calf muscles.
- Soreness along the back of the lower leg.
Bursitis of the posterior bursa of the Achilles tendon also occurs due to too small shoes or shoes with an uncomfortable heel. As a result, the patient may experience not only a callus on the heel, but also inflammation in the heel, internal pain.
So, Achilles bursitis, like a spur, is manifested by pain in the heel that gets worse in the morning. However, the treatment for each disease is different. Contact the specialists of the MC “Doctor Ost”: you will be accurately diagnosed and selected the correct treatment with modern technologies.
Rheumatoid arthritis, arthrosis, ankylosing spondylitis – these diseases arise due to infection or genetic breakdown and affect the entire body. To one degree or another, signs of arthritis can appear in all joints, but in some the process is more noticeable. Pain in the bones, in the heels often give these diseases in the first place. This is due, among other things, to the fact that there is a heavy load on the legs.
Suspecting a systemic course, the orthopedist will pay attention to the symptoms:
- Pain in both heels, not just pain in the left or right heel;
- it hurts to step, as with a spur, but the discomfort does not stop at rest;
- inflammatory processes are also noticeable in other joints – knee, hip.
- there are signs of infection, inflammation and in other organs.
Leg pain is concentrated in the heel if there are pathological changes in the spine at the level of the sacrococcygeal segment.Protrusion, hernia, osteochondrosis lead to soreness and decreased sensitivity of the limb below the knee. And with such diseases, pain in the heel after sleep manifests itself most actively.
Osteochondropathy in adolescents during the period of active growth due to a delay in the restructuring of this zone. Perhaps the only cause of heel pain that goes away on its own when growth stabilizes. nevertheless, it is possible and necessary to alleviate the child’s condition. Make an appointment with a restorative medicine doctor or neurologist at the Doctor Ost MC.
HOW TO TREAT HEEL PAIN
Even if the pain in the heels and legs appeared after a long walk and, it would seem, is quite understandable, most likely this is an alarming bell of the first symptoms of some serious illness. If the pains have become more or less regular, you need to go to the doctor. Any disease in the initial stages is treated much faster and more efficiently than in advanced stages.
Doctor Ost MC is ready to deal with heel pain of various origins quickly and effectively.To get rid of heel spurs and heel pain, treatment should be directed towards the elimination of the build-up. In the MC “Doctor Ost”, the heel growth is eliminated quickly and without surgery, using a modern non-surgical method – shock wave therapy.
With bursitis, arthritis, arthrosis, inflammation and microtrauma in the tendon is effectively removed by a high-intensity laser.
Alloplant injections will help strengthen local immunity, and PRP therapy is used to heal damaged tissues.
If it becomes clear that the treatment of heel pain should start with the spine, the unique robotic machines DRX and ExtenTrak will come to the rescue. They effectively cope with protrusions, osteochondrosis and hernias without surgery, relieving the load from the heel.
how much is
Heel pain is treated by a neurologist, orthopedic traumatologist, and a specialist in restorative medicine. The cost of a specialist consultation is indicated in the “Consultative reception” section of our price list.Follow the promotions, don’t miss out on the best price!
It hurts to step on the heel. What to do?
“Suddenly it was very painful to step on the heel. Please give advice on what to do. And why is this happening? ”
Nina Vitalievna Yakubovskaya, Baranovichi.
This is one of the symptoms characteristic of many diseases, or a consequence of an injury.Indeed, among the important functions of the foot is depreciation. The heel has increased sensitivity due to the fact that it contains a large number of nerve endings. Therefore, for any, even minor, damage, a person feels pain. It is necessary to understand what exactly it is caused by before taking further action.
But first of all, you need to pay attention to your shoes, especially for lovers of high heels. The tension of the feet is often a consequence of flat feet.It is also harmful to be constantly on your feet all day long. Excess weight or a sharp increase in it contributes to an increase in the load on the feet. And as a result of a sharp weight loss or physical overload in the heel, atrophy of the subcutaneous fat “cushion” occurs, which is also fraught with pain. It also occurs when walking, if the calcaneus is bruised and the surrounding tissues become inflamed.
However, the most common cause is a heel spur. The long plantar ligament supports the shape of the foot and provides shock-absorbing properties.The leg requires rest, but shoes with insufficient supination cause inflammation of the plantar fascia (fasciitis), which runs along the foot of the tissue that connects the heel to the toes. The result is severe pain, especially in the morning.
At the same time, a number of other diseases can cause heel pain. For example, an inflammatory process in the Achilles tendon due to constant stress on the calf muscles (climbing uphill, jumping), wearing uncomfortable shoes, constantly walking in high heels. Or it may be a disease of the spine, especially its lumbar spine.Sometimes latent infections or rheumatism give a characteristic picture in the form of reactive inflammation of the heels.
In each individual case, the treatment will differ depending on the cause. If there was an injury, then you need to contact an orthopedic traumatologist. You may need to consult a surgeon, neurologist, oncologist, phthisiatrician, rheumatologist. If you are not sure about the cause of the pain, then make an appointment with your GP. After the examination, he will refer you to the correct doctor. As a rule, an examination of the foot, ultrasound and X-ray examinations is sufficient for a diagnosis to be made by an experienced specialist.To eliminate pain in the heel, treatment of the underlying disease giving such a symptom is necessary. Pain relievers can only temporarily relieve you of the discomfort.
Treatment consists of:
• medication and physiotherapy methods,
• creating rest for the foot,
• exercise therapy.
Massage improves blood circulation, which helps not only to eliminate pain, but also to relieve the inflammation itself.The constant use of special insoles with an instep support and a heel cushion reduces the pressure on the disturbing area. At home, they resort to drugs such as non-steroidal anti-inflammatory drugs (tablets, injections, ointments). Corticosteroid injections into the painful area may be required. Folk remedies: herbal teas, soothing baths. Additionally, a tight bandage is used.
After heavy loads on the legs, an ice compress will help to quickly relieve pain in the heel. To do this, put ice cubes in a bag and apply to a sore spot.Keep the compress for 5 – 10 minutes.
To prevent the occurrence of painful sensations in the area of the foot, you should wear comfortable and correctly selected shoes. It is good if your shoes or boots have an orthopedic insole. The heel is no higher than four centimeters, the shoes should not be narrow. At home, you can do exercises for the legs: bend and unbend the feet in a sitting position for two minutes, roll a tennis ball on the floor with your feet. It is useful to take contrasting herbal baths. You should eat right and fight excess weight, walk barefoot on the grass and pebbles on the beach.At home, it is useful to walk on a rug with heated coarse salt.
Olga PERESADA, Professor of the Department of Obstetrics and Gynecology, BelMAPO, Doctor of Medical Sciences.
90,000 Heel pain when walking after sleep ♨ Articles
You woke up, get out of bed and, as soon as you put the load on your feet, pain in the heel penetrates you. The cause is plantar fasciitis or fasciitis, one of the most common complaints in orthopedics.This condition would be more accurately called fasciosis, since it is a degenerative disorder, not an inflammatory disease. (The ending “it” corresponds to inflammation: rhinitis, gastritis, etc.)
The plantar fascia connects the heel to the forefoot and acts as a shock absorber, supporting the natural arch of the foot while walking. The ligamentous apparatus of the foot is subject to daily “wear and tear” loads as a result of which damage to the ligaments occurs. The result is stiffness, discomfort, and pain.
- Plantar fasciitis symptoms
- Causes of occurrence
- Recovery from plantar fasciitis
for several months,
The main complaint associated with plantar fasciitis is pain in the lower heel and also in the lower part of the foot, closer to the middle.This process involves one leg, but the process can develop on both feet.
Pain from plantar fasciitis increases gradually. It can be either dull, aching or sharp. Some people experience a constant burning sensation.
Fasciitis is characterized by morning pain when you are just taking your first steps, getting out of bed, or after sitting for a long time, or when you have been lying down for a while. It also becomes difficult to climb stairs due to the tension in the ligaments of the foot.
People with plantar fasciitis usually do not feel discomfort during physical activity, but rather, pain occurs immediately after the activity stops.
The cause of plantar fasciitis is still not fully understood. It is known that both men and women aged 35 to 70 who lead an active lifestyle are at the highest risk of developing plantar fasciitis. Slightly more common in women than men. During pregnancy, attacks of plantar fasciitis may also appear, especially in the later stages.
Overweight people are at greatest risk of heel pain. This is directly related to the increased pressure on the fascia of the foot, especially if you put on extra pounds quickly and unexpectedly. Harmful factors include work associated with a long stay on their feet – waiters, guides, etc. sleep.
Although some doctors still believe that plantar fasciitis occurs in people with heel spurs, this is not at all the case.
For the purpose of differential diagnosis, the specialist will perform an examination to determine the exact location of the problem area and to make sure that the pain is not the result of other disorders.
During the examination they will check:
- change in the nature of pain with pressure and movement;
- presence of redness or swelling;
- muscle tone;
- coordination and balance.
Additionally, you may be sent for an X-ray or MRI scan to check if there are any factors causing heel pain. For example – a bone fracture.
Plantar fasciitis treatment
Home remedies for heel pain when walking after sleep include: rest, cold compresses, anti-inflammatory and special exercises. It is important that exercise and daily physical activity do not cause or provoke pain.
After receiving a specialist, you may be assigned the following procedures:
- Corticosteroid injections;
- Shockwave therapy;
- Orthopedic products.
If symptoms persist within 9 to 12 months, you will be offered a surgical option.
Supplement. Essential oils
Essential oils for the treatment of heel and foot pain:
- lavender oil;
- lemon grass oil;
- Eucalyptus oil;
- rose oil.
Remember to dilute the essential oil with the base oil (olive, almond, coconut …) before using it. You can use an aroma lamp (Not for massage, for inhaling beneficial vapors)) or take a bath with a few drops of aroma oils.
A few simple lifestyle changes can help you avoid heel and foot pain.
- Wear shoes that support the arch of the foot, and do not forget to regularly change to a new one, especially sports shoes (for those who are involved in jogging, this is 600 – 700 km of “run”).
- Include swimming or cycling in your schedule. Avoid overwork. Remember to stretch your calf muscles, Achilles tendon, and plantar fascia before exercising.
- Maintain your optimal body weight. If you are overweight, try losing weight to reduce stress on the plantar fascia and joints in general.
- Come to our meetings at the Freudian Heritage Club. Learn more. Take care of yourself and be healthy!
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90,000 Heel hurts after sleeping in the morning and painful to step on (pain when walking, stepping)
Some people experience pain in their feet in the morning when stepped on.This can be perplexing, because at night the legs rested, so they seem to be unable to hurt. But this problem is quite common; according to statistics, every tenth adult faces it.
General characteristics of pathology
The heel bone performs very important functions in the human body. With any movement, it bears the greatest load. A fat pad in this place softens shocks and shocks, being a shock absorber. In addition, a large number of nerve fibers and blood vessels pass in this place.Therefore, with increased loads and various pathologies, heel pain occurs quite often.
At the same time, it appears at the very first step after a long rest, for example, in the morning. A person is forced to take the first steps on tiptoes, because it is impossible to step on the heel. Then the pain gradually subsides. It can resume in the evening if a person has been on his feet for a long time.
Pain often occurs in the morning after intense physical activity
Why does pain appear
Most often, the feet hurt after physical exertion.Mostly women are affected by this pathology. This is due to the structural features of the calcaneus. In addition, many women wear heels, which puts more stress on the foot. Especially if you go all day in heels, and in the evening change into flat slippers.
Foot pain in the morning often also occurs in athletes, overweight people and those who walk for a long time during the day. If you go to bed after such a load without having done a massage or a relaxing foot bath, then after rest the pain will not go away, but it may intensify.This is due to the accumulation of lactic acid in the tissues or due to inflammation after microtrauma of the ligaments.
There are also diseases in which pain is felt constantly. In most cases, other symptoms are also observed. For example, diabetes mellitus or certain infectious diseases can cause complications in the feet. But it also happens that the pathology begins imperceptibly, and is detected only when it hurts to step on the heels. These diseases can cause pain at any time of the day, even in the morning after rest.If such symptoms appear, it is advisable to immediately consult a doctor so that he can help get rid of the discomfort.
The most common causes of heel pain are:
- Achilles tendon sprain or rupture;
- bruise or fracture of the calcaneus;
- flat feet;
- arthrosis or arthritis;
- ankylosing spondylitis;
- sciatica lumbar;
- diabetes mellitus.
Causes of morning pain
People who do not have serious endocrine diseases or pathologies of the musculoskeletal system may also face this problem. Then they wonder why the heels hurt in the morning after sleeping, because they rested at night.
But there are several pathologies that cause discomfort and painful sensations after prolonged immobility:
- plantar fasciitis;
- heel spur;
- varicose veins;
- violation of mineral metabolism.
Plantar fasciitis is one of the most common causes of morning heel pain.
In addition, pain in the feet in the morning can be caused by arthritis or arthrosis. These pathologies are often exacerbated not only after exercise, but also after prolonged immobility. Elderly people can also suffer from conditions such as metatarsalgia. This is a reduction in the fat layer on the heel, which reduces its cushioning properties. And the last cause of pain in this area can be deep cracks.During the night, the skin dries up, and after the first steps it cracks again, which causes severe pain.
Plantar fasciitis is the most common cause of heel pain after sleep. This pathology occurs due to inflammation of the plantar fascia – a ligament that runs through the entire foot and supports its arch. It is this ligament that connects the calcaneus to other structures in the foot. Therefore, she suffers most from increased physical exertion.
As a result of active work in the fascia tissue, micro-tears appear.Their cause may be deformity of the foot with flat feet, frequent wearing of high-heeled or flat-soled shoes, unusual physical activity. During the night, micro-tears heal a little, but this leads to a shortening of the ligament. This is why the heels hurt in the morning – at the first step, the fascia breaks again.
Women most often suffer from this pathology, as they like to wear uncomfortable shoes, as well as athletes. The risk group includes people who are overweight and those who spend a lot of time on their feet during the day.Flat feet and traumatic injuries of the foot can also cause the development of this pathology.
A growth may form on the plantar surface of the heel bone, which causes severe pain.
The main symptom of plantar fasciitis is the heel hurts and it hurts to step on it in the morning after sleep. Most often, the pain is concentrated in the front of it on one leg. It usually decreases after a few steps. But it can again occur when going up or down stairs, walking or running for a long time.If these symptoms are ignored and plantar fasciitis is not treated, chronic inflammation can lead to the deposition of calcium salts and the formation of growths on the heel bone, more commonly known as a heel spur.
With a prolonged inflammatory process in the soft tissues of the foot or with constant increased loads in the area of the calcaneal tuberosity, conditions are created for the deposition of calcium salts. A bony outgrowth appears, which can have a different shape. Most often it looks like a thorn, so the pathology is called “heel spur”.Overweight people with flat feet are most susceptible to this pathology. There is a “spur” mainly in women after 45 years. This is due to the frequent wearing of uncomfortable shoes and metabolic disorders.
Such a build-up, when walking, irritates soft tissues, causing pain. It is especially difficult to get up in the morning after resting. Patients describe these sensations as if they were a nail in the heel. But gradually the pain may decrease. Without treatment, a heel spur leads to severe inflammation of the soft tissues, the formation of corns, and in the future – to the inability to step on the heel.
Pain in the foot in the morning can occur due to gout
This pathology is associated with metabolic disorders. In this case, the deposition of uric acid salts occurs. The joints of the foot are most often affected, since they are located on the periphery and are subject to increased physical exertion. The most common places of localization of gout are the big toe, as well as the heel bone.
With this pathology, pain occurs mainly in the morning. When a person wakes up, he notices that the heel hurts a lot.In addition, it turns red, swells, it is impossible to even touch it.
Chronic venous insufficiency
This pathology is known as varicose veins. Mostly women after 40 years of age also suffer from it. This is not only due to the increased stress on the legs due to wearing high heels. With age, blood circulation slows down, the elasticity of blood vessels decreases.
Varicose veins can also lead to pain in the foot in the morning.This is due to the fact that blood circulation is slowed down at night, so the venous outflow from the legs is further reduced. The feet swell, it becomes painful to step on the feet. This is often the first symptom of an incipient pathology.
During pregnancy, there is often a violation of mineral metabolism, which is why feet hurt in the morning
Violation of mineral metabolism
Such a problem may arise due to a lack of potassium and magnesium in the body. These are the minerals that are responsible for the muscles and ligaments.With a decrease in their amount in the blood, painful convulsions occur. Such a pathology can develop in adolescents during a period of rapid growth, in pregnant women, in the elderly.
Most often, such cramps are localized in the gastrocnemius muscle and in the foot area. They mainly occur in the morning, as the amount of potassium and magnesium decreases even more during the night. After cramps, painful sensations may remain, due to which it is impossible to step on the foot.
It is possible to apply certain methods of treatment only after examination by a doctor.He will help determine why it hurts to step on the heel, and prescribe treatment. Indeed, each pathology has its own therapeutic methods: what helps with plantar fasciitis will be useless for gout. There are, of course, common therapies that help relieve pain in the feet in the morning. These are various pain relievers or anti-inflammatory drugs used internally and externally. Effective are “Ibuprofen”, “Diclofenac”, “Indomethacin”, “Ketorol”. But they only relieve symptoms, without protecting against the recurrence of pain.
For any pathology, painful sensations can be removed with cold compresses. They are applied to the heel several times a day. You can keep the cold for no more than 15 minutes. For a compress, it is best to use a frozen plastic water bottle or bagged beans. Compresses with “Dimexidum” or medical bile also help. And in case of pain due to overwork, it is good to do contrasting foot baths at night. This will prevent pain in the morning.
Special therapeutic exercises, massage and physiotherapy are also effective.They help to increase the elasticity of the muscles and ligaments of the foot, improve blood circulation and metabolic processes. These methods are helpful for any cause of morning heel pain. Contrast foot baths, walking on massage mats, and from physiotherapy – electrophoresis and magnetotherapy are especially helpful. Recently, the method of shock wave therapy is gaining popularity. Just a few sessions are able to return a person to freedom of movement.
Effective for the treatment of heel pains shock wave therapy
Treatment of plantar fasciitis
If morning pains are caused by plantar fasciitis, the main thing is to ensure complete healing of the ligament and reduce the inflammatory process.To do this, it is recommended to limit the load during the day, walk only in orthopedic shoes or using special insoles with heel pads and instep supports. Effective taping – gluing elastic tapes on the foot. They relieve the stress on the plantar fascia, partially performing its functions.
In plantar fasciitis, heel pain when walking after sleep occurs most often due to repeated tears of the ligament tissue. To prevent this process, it is recommended to use a brace at night.These are devices that keep the fascia stretched, as if standing. As a result, micro-tears heal in this position, and after stepping on the feet in the morning, no pain occurs.
It is not necessary to buy special braces, you can make such a device yourself. To do this, you need to put on a long golf or stocking. Tie his sock with a ribbon and fasten it to the lower leg so that the ankle joint is at a right angle. For the same purpose, it is recommended to wear real felt boots with a rigid structure at night.
If pain in the feet occurs frequently in the morning, you should consult a doctor. After all, this may be a symptom of an incipient serious illness. And without timely treatment, it will progress.
What is plantar fasciitis and how to treat it
Plantar fasciitis, or, as doctors say, plantar fasciitis is one of the most common causes of foot pain in the adult population. What is the basis of the disease and how to cope with it?
The disease has such characteristic symptoms that it is simply impossible not to notice it or confuse it with any other disease.The main symptom of plantar fasciitis is heel pain. In the morning after waking up, excruciating colic occurs in the sole, which renews with each step. Doctors call this phenomenon morning pain of the first step. After a short period of time, the pain subsides, but the next morning or after a short rest it recurs again. Many patients complain of pain after a long walk. The pain syndrome is based on inflammation of the plantar fascia – a layer of tough connective tissue that, like a cable, connects the heel bone with the metatarsal bones and supports the longitudinal arch of the foot.
Several factors are known to contribute to the development of plantar fasciitis. The most proven of them is the presence of flat feet, a pathological condition accompanied by flattening of the arch of the foot, as a result of which the plantar fascia is excessively stretched and strained. The part of the fascia that is attached to the heel bone is most severely damaged, and therefore the inflammation in this place is most pronounced. Another risk factor is overweight, which entails an increase in the load on the foot and, accordingly, the plantar fascia.Changes in habitual physical activity, such as excessive exercise or hard work, can also trigger fasciitis.
Without treatment, heel pain can bother for several months or constantly, then receding, then reappearing. As a result of chronic inflammation and “deposition” of calcium salts in the place of fixation of the plantar fascia to the calcaneus, a bony protrusion, or “heel spur”, is formed. Many patients consider her to be the culprit of unpleasant symptoms, but this is not entirely true.The pain is caused primarily by inflammation, and the “spur” is already its consequence. That is why plantar fasciitis requires a full-fledged treatment, which is always based on stopping inflammation and eliminating the cause of the disease.
Conservative therapy is complex and usually includes a combination of several methods. You can start with stretching – gymnastics for stretching the muscles of the foot and calf muscles. When exercised on a regular basis, they can effectively reduce heel pain.Along with gymnastics, non-steroidal anti-inflammatory drugs also relieve pain, but their long-term use is unsafe due to the large number of side effects. It is very useful to wear individual orthopedic insoles adjacent to the foot over the entire area, which are made individually for each patient. They allow you to restore the normal height of the arch of the foot already in the first weeks of constant wear and, thus, reduce the tension of the plantar fascia. Currently, this particular method of treatment is considered the most effective and guaranteeing long-term results.Another therapeutic area is the use of so-called “night splints” – special orthopedic devices that resemble a plastic boot. They, of course, can reduce the pain of the first morning step, but they are rather bulky and not very convenient to use. Shock wave therapy, which is also used for other diseases, has a certain positive effect, but it does not always completely stop the pain syndrome, and the achieved result does not last long. Local administration of hormones (corticosteroids) to the site of inflammation and surgery are extreme measures that are resorted to only in cases where other methods of treatment have not brought the desired result.Therefore, do not neglect the doctor’s recommendations on gymnastics and wearing special insoles. It doesn’t take much effort to do this.
Take care of your feet!
Vladimir KHRYSHCHANOVICH, Doctor of Medical Sciences.
Heel pain | SHiFA Medical Center
Aching or sharp, with lumbago, pain in the heels is a symptom of diseases of various etiopathology. Discomfort and painful sensations can manifest themselves only in the morning, torment with prolonged walking, and be felt constantly.Why does heel pain occur and how to get rid of it? Can you tolerate it and how can it turn out?
How is heel pain expressed?
Heel pain can be expressed in various manifestations:
- Swelling, redness, lump, inflammation of the Achilles tendon or talus;
- inflammation of the soft tissues in the area of the calcaneus and subcutaneous bursa;
- pain in the area of the foot on the heel, closer to the arch of the foot, etc.
How common is heel pain
Pain in the heels is one of the main reasons for patients’ complaints to an orthopedic traumatologist. This state of affairs is due to the high prevalence of symptomatic diseases and the multifactorial nature of the causes.
Overweight people, athletes, representatives of many professions who, by the nature of their service, have to spend 8-12 hours on their feet (hairdressers, turners, movers, salesmen, teachers, etc.) suffer from heel pain.).
Gender prevalence is related to the underlying cause. For example, gouty heel pain occurs mainly in men after 35. Crystalline arthritis caused by endocrine and metabolic disorders occurs in both sexes, predominantly in the elderly. Also, the risk group automatically includes those suffering from diabetes and obesity, regardless of gender and age.
What diseases may be associated with heel pain
Heel pain can be caused by many different external and internal factors.For example, most overweight people are familiar with this symptom because of the heavy load; it is often encountered by those who spend a lot of time on their feet and wear uncomfortable shoes.
Also, pain in the heels can be a symptom of the following inflammatory diseases of the musculoskeletal system, ligamentous apparatus:
- Plantar fasciitis is a familiar heel spur. It occurs as a result of inflammatory and degenerative pathological changes in the tendons in the area of the calcaneal tuberosity.With increased stress, the aponeurosis becomes inflamed, causing severe pain when walking.
- Achillitis (ankle tendonitis) – inflammation of the Achilles tendon. It can be caused by flat feet, anatomically irregular shape (curvature, deformation) of the ankle, traumatic injuries, prolonged squeezing with shoes (especially when climbing a mountain). It is manifested by tissue hyperemia, sharp, often unbearable pain.
- Achilles bursitis – inflammation of the bursa or bursa in the area of the Achilles tendon.It can develop against the background of infectious diseases spreading by the hematogenous route, against the background of arthritis and arthrosis of the foot, systemic diseases of the connective tissues and joints, after injuries.
- Gout – deposition of uric acid salts due to impaired purine metabolism. Primary or secondary rheumatic disease. Often provokes arthritis, which also manifests itself in the talocalcaneal joint.
- Heel joint arthritis – rheumatoid or reactive monoarthritis, polyarthritis, periarthritis.Among the causes of monoarticular lesions of the heel are trauma, some forms of arthropathy, for example, it often appears with chondrocalcinosis. Periatritis of the soft periarticular tissues have a rheumatic etiology, the process can be localized in the joint capsule, fascia, tendons and their membranes, enthesises of the heel joint, causing severe pain in the heel.
Why You Can’t Ignore Heel Pain
Heel pain can have a different etiology, but the result in most cases is inflammation of the soft tissues, cartilage of the joint.Due to the fact that the heel constantly has to experience stress when walking, the symptom does not go away without adequate treatment. The disease progresses, causing severe pain, which often becomes unbearable when walking. Therefore, in most cases, therapeutic or surgical treatment is required.
There is also a possibility of benign and malignant neoplasms, which can externally manifest themselves as monoarthritis and other diseases. Therefore, for any inflammatory process, with pain in the heels, it is necessary to undergo an examination and find out the true cause.
Which doctor should you contact if you have heel pain
In case of pain in the heel, it is necessary to make an appointment with an orthopedic traumatologist. Depending on the symptoms and external manifestations, the doctor will prescribe diagnostic procedures for examination. You may need to pass laboratory tests, do CT, MRI, X-ray, ultrasound. After that, it will be possible to judge the localization and degree of development of the process that provoked pain in the heels.
When this symptom appears, you cannot independently warm the sore spot, apply warming ointments to the heel and make compresses.Any self-medication can aggravate the disease and cause complications.
why it hurts to come in the morning after sleep, how to treat a disease
Morning heel pain is one of the most common pain conditions that many people experience. The most common reasons that lead to this discomfort, experts call increased physical activity, injuries and other serious diseases.
If you have been feeling unpleasant pains for many weeks, then you shouldn’t wait any longer.You need to see a doctor as soon as possible in order to understand what caused their appearance, as well as undergo treatment so that you are no longer bothered by pain after sleep.
Why does a person worry about heel pain in the morning?
Human heel consists of the calcaneus and fatty layer , which is responsible for the aromatization function. This helps to avoid discomfort when walking and running and to cope with significant loads.
Most often, a person feels pain in the heels due to the following reasons:
- Increased physical activity;
- Use of new, narrow shoes with high heels;
- Hours of walking or work activity.
- Diseases of an infectious nature;
- Chronic diseases of the musculoskeletal system of an inflammatory nature.
Usually, if experts declare any of the first three factors listed above as as the main cause of heel pain , then this often indicates a disease such as fasciitis. With further progression of the disease, there is a likelihood of salt deposits in the heels, and this leads to the formation of bone tissue and the overflow of the disease into a chronic form.
In the group of diseases that can provoke the onset of pain in the heels, it is customary to include the following:
- Inflammations of various types;
- Heel spur, the appearance of which can provoke flat feet;
- Injury of tendons;
- Plantar fasciitis;
- Ordinary and rheumatoid arthritis;
If you have had pain in the heels for a long time , especially in the morning hours, then you should not delay and see a doctor as soon as possible.Based on the results of the examination, he will be able to establish the cause of the disease, as well as choose the correct and effective treatment for you.
Traditional medicine and heel pain
In cases where heel pain when walking occurs due to damage to tendons , the patient is shown strict bed rest for at least two weeks. To make the pain less bothersome, anti-inflammatory drugs are prescribed. Ibuprofen, diclofenac, indomethacin have an excellent anti-pain effect.
Therapy for this disease can include laser therapy , transverse massage in combination with ointments, as well as a shock wave method. If the pain becomes very acute, then they resort to the procedure for administering corticosteroids – hydrocortisone or Kenalog.
But not always, even the above treatment methods help to remove pain when walking. In this case, the patient needs to undergo X-ray therapy.
In cases where the cause of heel pain when walking is an infectious disease, treatment should be directed towards eliminating the underlying infection.For this, the patient is prescribed antibiotics, compresses, ointments and anti-inflammatory drugs. In some cases, a blood test may be required to determine the cause of heel pain. The presence of inflammation in the blood is a strong signal that heel pain when walking is caused by ankylosing spondylitis. A characteristic symptom of gout is an increase in the concentration of uric acid in the blood. In any of these cases, it is necessary first of all to deal with the treatment of the underlying disease, which will help to quickly relieve pain when walking.
Treatment of plantar fasciitis
In most cases, in the morning hours, pain in the heels bothers if a person has plantar fasciitis, which most often occurs as a result of microtrauma or inflammation of muscle tissues. Over time, the pain begins to be felt not in a limited area, but over the entire area of the foot.
Microtrauma at the junction of tissues with bone cause inflammation of tissues , which subsequently leads to pain.At night, the lesions have time to heal, as a result of which the fascia is shortened. Waking up in the morning, a person steps on the foot, which leads to another damage to the fascia, to which the body reacts with a new pain syndrome.
Therapy for plantar fasciitis assumes compliance with the following recommendations:
- Restriction of physical activity;
- Performing medical gymnastics;
- Use of footwear with special orthopedic insoles with instep supports;
- The diseased foot must be fixed in one position, thereby allowing the fascia to heal properly;
- Before going to bed, a brace is applied to the foot;
- Taping can be used as a method of influencing the disease;
- To eliminate acute pain in the heel, hydrocortisone is injected;
- Shockwave therapy is considered an effective treatment;
- In isolated cases, a doctor may decide to perform an operation.
Taping is not such a common method of treating such a condition , but its essence lies in gluing the foot with a special tape or adhesive plaster. Moreover, it is necessary to tighten the tape in such a way that it partially takes over the functions of the plantar fascia, while simultaneously reducing the load on the tissue.
For heel pain relief when walking , a brace can be used which has also proven itself. The therapeutic effect is provided by the fact that pain in the morning hours is associated with the next rupture of accrete fascia with shortening.This is due to the fact that a person pulls out his socks during sleep. Braces can be used to position the fascia so that the tissues remain stretched at all times. After some time after using the braces, you can notice how in the morning the pain begins to subside and one day may completely disappear.
If necessary braces can also be made on our own . They will need a long golf course, which must be tied to a strap and secured in the calf muscles.Also, the braces can be replaced with real high-quality felt boots. They have a rigid construction, so you don’t have to worry about stretching your foot while sleeping.
Although fixation of the foot causes some discomfort for a person, however, it is beneficial in that it helps the injured fascia to heal properly, removing painful sensations in the morning hours in the heels.
Traditional medicine in the fight against heel pain
Folk remedies are also effective for treating heel pain , but they must be used only after receiving approval from the attending physician.From the moment when a person first learned about this disease, traditional medicine has been able to accumulate many effective methods of treating it.
The best effect in the treatment of this disease gives the alternate exposure to heat and cold. To do this, you need two basins: warm water is poured into one, and cold water into the other. The essence of the procedure is to alternately lower the sore foot into water of different temperatures.
Can also be used for healing with ice cubes.They massage the damaged area, but this should be done no more than 7 minutes. For a therapeutic effect, this procedure is recommended to be done 5 times a day.
The following traditional medicines can also be used to treat heel pain:
- You need to take a whole egg, add 100 ml of vinegar and the same amount of butter to it. This mixture must be allowed to brew for 21 days in the refrigerator. The mass is stirred periodically. When the product is ready, you need to steam the foot well, and then apply the medicine to it, after which you need to put on socks.In case of burning sensation, you must immediately put your foot under cool water;
- To prepare this product, take 75 ml of ammonia and 25 g of vegetable oil. In this mixture, you need to blot a cotton swab, and then put it on the sore foot for half an hour;
- You need to take 3 heads of cabbage, grind them on a grater, and then add to boiling water and leave to infuse for 30 minutes. After the specified time has elapsed, warm water is poured into the mixture so that the temperature becomes comfortable, after which the feet are dipped into this bath and held for at least 20 minutes;
- For the treatment of pain in the heel, you can use a tincture of propolis, which is applied to the foot and bandaged with a bandage;
- You need to take 1 liter of clean water, put 3-4 walnuts in it.This mixture is sent to a sunny place for infusion for two weeks. The medicine is used to prepare compresses, which are done in the evening. Usually one course is enough for more in the heel to go away completely;
- You need to take 40 ml of vinegar, add 1 cup of turpentine and two eggs to it. Having thoroughly mixed all the ingredients, you should get a healing mixture, which is applied to the heels three times a day for 4 hours.
- To relieve heel pain, you can use church oil from miraculous icons or oil from unction.Treatment consists in applying the product crosswise to the affected area;
- You can try to treat pain with nettle leaves, which are placed on sore heels, making compresses from them. The duration of one course of treatment is 1 month;
- Another remedy can be made from garlic: it must be thoroughly chopped and used as compresses that are made overnight. In the morning they are cleaned and massaged;
- To prepare the next product, take lilac flowers and vodka in a ratio of 1:10.This mixture should stand for 10 days, after which sore heels are treated with it, or it can be used to make compresses. The course of treatment lasts 1 month.
You can also offer a few more recipes for remedies that effectively relieve heel pain when walking:
- To reduce stress on the feet and to avoid skewing when wearing shoes, heel pads can be used. These products are very diverse and have different shapes and textures, therefore, to choose the most suitable model, you need to seek advice from a doctor;
- Shoe liners can be used to treat the symptoms of heel fasciitis.Such products provide a uniform load on the heel, thereby relieving pain during movement;
- If painful sensations in the area of the foot have to be felt constantly, then you need to change your usual shoes to orthopedic;
- It is necessary to make it a rule to regularly massage sore heels.