Do you have tender heels?

Dr Douglas Street, Contributor

Many of us take our feet for granted unless something goes wrong with them. With all the use and abuse our feet get, it's no surprise that they sometimes develop painful conditions. Plantar fasciitis is one such condition that causes pain in the feet.

Plantar fasciitis is fairly common condition. As its name suggests, it is thought to be an inflammatory condition of the plantar fascia, which is a ligament that connects the front of the foot to the heel and is the main support for the arch of the foot. This arch is important as it helps to spread the weight of the body properly throughout the feet. This fascia is, therefore, under a lot of pressure.

Plantar fasciitis causes pain in the heel, which is most severe with first steps in the morning. The pain is also worse after sitting or standing for a long time, climbing stairs, or other significant exertion.

It affects both sexes and is more common in the 40-70 age group. It is more common in persons who spend long periods of time on their feet, are overweight (especially if recently so), have a tight Achilles' tendon, have flat feet or high arches, do long-distance running, or wear shoes with poor arch support. It was once thought a bony spur, which may develop in the portion of the ligament attached to the heel, was the cause of the pain, but this has been disproved as the spur may be present with or without the condition.

Interventions

Foot-stretching exercises, which involve pushing the distal portion of the feet upwards, have been shown to help. Splints that keep feet stretched in this position may give some pain relief. Icing the feet a couple times a day may also give some relief. Resting the feet for about a week is also advisable. Wearing shoes that give proper support to the arch and provide cushion to the heel may also be helpful.

Medical intervention may involve a strong pain reliever such as an anti-inflammatory. A doctor may also give a corticosteroid injection combined with a local anaesthetic at the site of the problem, which usually gives immediate and long-lasting relief, but sometimes needs repeating. Surgical intervention may also be necessary, but is a last resort.

Dr Douglas Street is a general practitioner and has private practices at Trinity Medical Centre, Trinity Mall at 3 Barnett Street in Montego Bay, and Omega Medical Centre at Plaza de Negril, Negril. Send feedback to drdougstreet@yahoo.com.