Heel Pain - Plantar Fasciitis

Plantar fasciitis is a common cause for foot/heel pain evaluated by primary care providers. It’s something that happens in adults of varying activity levels, from those who are sedentary and overweight to those who are avid long distance runners. The presentation is classic, and usually all that is needed to make the diagnosis is a history and physical exam (meaning usually no need for x-rays!). Patients with plantar fasciitis experience pain at the bottom of the heel, most pronounced when first starting to walk. For example, the first steps getting out of bed in the morning can be excruciating, but then all is well by the time you leave for work. The pain returns with walking after periods of inactivity throughout the day.

The plantar fascia is a thick white tissue that connects the heel bone to the toes, and provides support for the arch of the foot. Having flat feet is a risk factor for developing plantar fasciitis, and walking around bare foot usually exacerbates the pain. The good news is that plantar fasciitis usually improves with time. Doing stretches and exercises at home can speed recovery, and using arch support with inserts or supportive shoes may help as well. Persistent cases may require a referral to podiatry or orthopedics for a steroid injection, but usually this is not necessary - about 80% of patients will have complete resolution of their symptoms within a year.

So if you recently started getting outside and going for walks thanks to this gorgeous weather, but are starting to notice discomfort in one area or another, consult with your DPC provider now! Addressing a pain while it’s whispering rather than screaming will likely give you a better chance of preventing a more serious injury!