Q: Since the weather has begun to improve from the recent very cold snowy conditions, I’ve been walking outside for exercise and because it seems to help my mood.
However, I’ve started to have pain along the bottom of one of my feet that seems worst under the front part of the heel, and it hurts more when I stand on that foot or push off with the toes of that foot when walking. What could be causing this, and what can I do about it?
A: You almost certainly have plantar fasciitis, a condition that affects about 1 million Americans every year. This can occur in very active and sedentary individuals alike. Risk factors include being overweight, having either “fallen arches” or unusually high arches, ankles that roll inward with weight-bearing, excessive running (particularly in shoes that are not meant for running) and excessive standing, either barefoot or in shoes with poor support.
Pain is usually felt first beneath or just in front of the heel and often will radiate along the bottom of the foot toward the toes but does not usually affect the front part of the foot. It is caused by irritation or inflammation of the thin ligaments in this area that support the body and maintain the arch of the foot.
About 90% of such cases improve with conservative measures, such as avoidance of painful activity, massaging the area with a cold pack, anti-inflammatory medications such as ibuprofen or naproxen (low doses of these meds are available without a prescription) and gentle stretching.
Sometimes physical therapy techniques, night splinting, foot orthotics (shoe inserts) or steroid injections are necessary, but these require seeing a physician. The best way to avoid this problem in the first place is to increase your exercise level gradually, allowing your muscles and joints to become accustomed to the activity, and to wear properly fitting shoes specifically meant for walking.
To learn more about this and many other health topics, visit the American Academy of Family Physicians’ website, familydoctor. org, where you can search for your topic of interest.
I want to thank Kathy R. for this question; if you have any particular topic you would like to hear more about, please message me at paulmdake@gmail.com.
Dr. Paul Dake, a Newberry native, is a retired family physician. He lives in Pinconning, Michigan.
