Dr Sanjiv my bottom of heel aches especially first few steps of the day.Its very painful,my Neighbour says it’s plantar fasciitis .Common questions and answers by Dr Sanjiv Rampal Orthopaedic Consultant Petaling Jaya Kuala Lumpur.

Doctor im having severe heel pain especially in the first few steps of the day?Do I have a problem ?What is Plantar fascitis Doctor Sanjiv,Im very afraid as it limits my housework abilities?

What is Plantar Fasciitis or heel pain?

Plantar Fasciitis is a common cause of foot and heel pain.It is due to inflammation or natural body reaction of the fibrous layer ligaments that run along the bottom of the foot that extends from heel to your toes. Plantar fasciitis is one of the most common causes of heel pain and has been estimated to affect about two million people in the US, resulting in more than one million visits to both primary care physicians and foot specialists.

How does Plantar Fasciitis commonly present?

Pain is usually described like sharp pain like needle piercing /stabbing pain on the heel of the foot .Usually it varies in presentation due to cause. The pain is located on the bottom of her feet at the heel and is severe, especially on the first step out of bed in the morning and after a long day at work or when change when standing up after sitting for a long time.

Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting.

Who is more prone to get Plantar Fasciitis?

Plantar fasciitis is more common in runners, long distance runners,ballet dancers and aerobic dancers due to prolonged exposure.
Flat feet,high arch or abnormal walking patterns often abnormal weight on foot.
Common among factory workers,teachers and receptionist due to long standing hours.

People who are overweight and those who wear shoes with inadequate support also have an increased risk of plantar fasciitis.Plantar fasciitis affects both sedentary and athletic people and is thought to result from chronic overload either from lifestyle or exercise also patients who have experienced sudden weight gain.

Even though plantar fasciitis can develop without an obvious cause, some factors can increase your risk of developing this condition. They include:

How to confirm it is Plantar Fasciitis?

Well it needs to seen by Orthopaedic specialist who will need proper history ,physical examination and location of pain.Your surgeon may order a x-ray or radiograph or rarely MRI to rule out other causes of heel pain and locate bone spur.

How do I treat it?
Patients often benefit from non surgical treatment in this condition.
Modes of treatment would include

Shoe silicon heel inserts

Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) may ease the pain and inflammation caused by plantar fasciitis.

Physical Therapy /Physiotherapy – a series of stretching and muscle strengthening would benefit

Rarely night splints may be advised

If pain is severe and unresolving in selected few ,I would suggest

Surgical options would include Cortisone injection, Extracorporeal Shock therapy and Ultrasonic repair would be prescribed rarely .

Dr Sanjiv Is there any home remedy or exercises I can do to make it all go away?

Change of sport of interest to low impact sport such as cycling or walking

Maintaining ideal weight

Proper footwear with heel support

Heel Silicon gel pad

Ice packing intermittently for not more 15 minutes helps reduce inflamation.

Plantar stretching of sole of the feet and simple stretching exercises go a long way in healing and resolving heel pain.

Preparing for your appointment

While you may initially consult your family physician, he or she may refer you to a doctor who specializes in foot disorders,orthopaedic surgeon or sports medicine.