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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Persistent Heel Pain?

I have had a sharp pain in my heel when I get out of bed in the morning, or when I stand up after sitting a while. It started 10 days ago, but got much worse today. Yesterday I walked the circumference of the mall 8 times, not wearing walking shoes (i.e. sneakers). I need a cane to walk. Is that the cause for the flare up. How can I relieve the pain?
Mon, 4 Sep 2017
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Orthopaedic Surgeon 's  Response
your symptoms sound typical of plantar fasciitis. its a common condition related to footwear and ageing.
basically the culprit is tight ankle flexors, ie the achilles tendon. this leads to microtears in the plantar fascia especially where it attaches to the heel. the inflammation and further microtears from a tight achilles tendon make the symptoms worse and worse.
i would recommend:
1. anti-inflammatories to reduce the inflammation
2. regular achilles tendon stretching. this can be either done by pulling with a towel (while sitting) or using your body weight to extend the ankle against the floor (standing, leaning forwards with straight hip and knees). regular stretching exercises will relax the muscle and fascia, allowing it to heal properly.
3. for very acute debilitating pain, an injection can be performed to numb the area and also reduce the inflammation. however it the proper exercises are not performed after the injection, the symptoms will recur.
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What Causes Persistent Heel Pain?

your symptoms sound typical of plantar fasciitis. its a common condition related to footwear and ageing. basically the culprit is tight ankle flexors, ie the achilles tendon. this leads to microtears in the plantar fascia especially where it attaches to the heel. the inflammation and further microtears from a tight achilles tendon make the symptoms worse and worse. i would recommend: 1. anti-inflammatories to reduce the inflammation 2. regular achilles tendon stretching. this can be either done by pulling with a towel (while sitting) or using your body weight to extend the ankle against the floor (standing, leaning forwards with straight hip and knees). regular stretching exercises will relax the muscle and fascia, allowing it to heal properly. 3. for very acute debilitating pain, an injection can be performed to numb the area and also reduce the inflammation. however it the proper exercises are not performed after the injection, the symptoms will recur.