What is this pain on the bottom of my foot? 🤕

Malani (age 45), a school teacher, came to my clinic last Tuesday. She entered the clinic room with a slight limp.

"Dr. Priya, I have recently been unable to get out of bed in the morning and put my foot on the ground. I feel a sharp pain under my heel, as if I were being stabbed by a needle. The pain subsides a little when I walk a few steps. But when I continue to stand while teaching at school, the pain increases again in the evening and becomes unbearable. I thought it was just a normal ache from exertion, but it has been going on for two months now," Malani explained her discomfort.

I examined Malani's foot and explained: "Malani, what you are describing is the classic symptoms of a condition called Plantar Fasciitis . Our feet have a strong band of tissue that runs from the heel to the toes and supports the arch of the foot. This is called the plantar fascia . Because teachers like you have to stand on hard ground for long periods of time, and because you have recently started exercising without proper preparation, this tissue has developed tiny microtears . The inflammation that has occurred is the cause of your pain."

🚨 Red Flags that require immediate medical attention

Although heel pain is common, you should see a doctor immediately if you experience the following symptoms, as they could be a sign of another serious condition:

• Sudden severe swelling, redness, or extreme warmth in the heel or ankle area, along with fever (may be a sign of infection).
• Unable to bear weight on the foot at all or having difficulty walking at all (could be a fracture or ligament tear).
• Persistent numbness, tingling, or weakness in the feet or toes (may be a sign of a pinched nerve).
• If you are a diabetic and develop a puncture or small wound in the skin in the heel area.

The main causes of plantar fasciitis

• Wearing the wrong footwear: Frequent wearing of sandals, worn-out shoes, or high heels that do not provide proper support to the arch of the foot.
• Standing for long periods of time: This risk is higher for people who work in jobs such as teachers, police officers, and shop assistants.
• Obesity: As body weight increases, the pressure on the heel tissue increases with each step.
• Foot structure: Flat feet or high arches.
• Aging: This disease most commonly occurs between the ages of 40 and 60, when tissue flexibility decreases.
• Associated diseases: Diseases that cause inflammation in the body, such as diabetes and rheumatoid arthritis.

Simple healing exercises that can be done at home

Physical therapy includes the following activities that can be done at home to increase tissue flexibility and relieve pain quickly:

1. Tennis Ball Massage: Sit in a chair and place a tennis ball or a can filled with water under the sole of the painful foot and slowly roll it from heel to toe. Do this twice a day for 5 minutes.
2. Calf Stretch: Stand facing a wall with the injured leg behind you and your heel touching the floor, holding for 30 seconds. This will relax the calf muscles.
3. Toe Stretch: Sit on the bed, grab a towel, place it on your toes, and slowly pull it towards you. Hold for 20-30 seconds.

Do's & Don'ts

Scientific sources (References)

• 📚 Plantar fasciitis - NHS
• 📚 Plantar Fasciitis: A Concise Review - PMC