When is it more than plantar fasciitis?

Working professionals are often on their feet, running to meetings, using standing desks, or driving long distances. All of these activities can contribute to heel pains. However, ongoing heel pains cause constant concerns and reduced focus.

Typical symptoms of plantar fasciitis

• Pain on the ventral (bottom) surface directly underneath the heel
• Pain standing up from a non-weight bearing period
• Pain improves after walking on it, initially at least
• 1st step out of bed in the morning is the worst

Risk factors include

• Joint issues (i.e., knee, hip, back)*
• Playing sports (i.e., dashing)
• Obesity or overweight
• Prolonged standing
• High arch anatomy
• Inproper footware
• Tight Achilles

*Mechanical heel pain <-- more weight bearing <-- knee/hip pain of the other side

Associations that may suggest an underlying issue with heel pain

• Recent trauma (i.e., stumping, driver in an accident) --> heel fracture
• Foot drop and low back pain (Sacral 1)--> referred nerve pain
• Numbness, tingling, burning --> nerve entrapment
• Fever, joint swelling-->rheumatoid
• Prolonged heel pains > 45 days*

*A foot X-ray is indicated if ongoing heel pain despite management to rule out anatomical issues like a bone spur.

Untreated heel pains can lead to chronic pain, so a workup is indicated if unresolved. Address any of the above-noted?associations?with heel pain if they exist; otherwise, other self-guided therapies can help.

• Weight reduction (1 lb ?? = 3-5 lb ?? per step on weight-bearing joints)
• Proper footwear with orthotics fitting, arch support if indicated
• Plantar fasciitis specific stretches involve the Achilles
• If limited in time, at least stretch the Achilles daily
• NSAIDs (i.e., ibuprofen) if allowed to use
• Epsom salt bath soak of affected foot
• Proper walking mechanics training

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