What Causes Morning Heel Pain and Plantar Fasciitis

Understanding Morning Heel Pain and Plantar Fasciitis

Waking up with a stabbing, throbbing, or sharp pain in the bottom of the heel is an experience many people are unfortunately familiar with. This pain, which is often most intense with the first steps after getting out of bed, has a variety of potential causes. However, one of the most common explanations is a condition known as plantar fasciitis.

What is Plantar Fasciitis?

Plantar fasciitis refers to inflammation of the plantar fascia, which is a thick band of fibrous connective tissue running along the bottom of the foot from the heel bone to the base of the toes. Acting like a shock absorber, the plantar fascia helps support the arch of the foot and enables pushing off during walking or running. When this important structure gets strained and inflamed, it can provoke heel pain and dysfunction.

Plantar Fasciitis Symptoms

In addition to morning heel pain, some other common symptoms of plantar fasciitis include:

• Stabbing or throbbing pain with taking the first steps after waking
• Pain decreasing somewhat after walking for a while, then worsening towards the end of the day
• Sharp heel pain or tightness after prolonged sitting or resting
• Tenderness focused on the inner heel and arch
• Swelling or bruising of the heel area in some cases

What Causes Heel Pain from Plantar Fasciitis?

There are several factors that can contribute to excessive strain and microtearing of the plantar fascia, provoking pain and inflammation:

• Overpronation (excessive inward foot rolling)
• High arches or flat feet disrupting force dispersion
• Tight calf muscles putting extra strain on the plantar fascia
• Excess weight placing added stress on the feet
• sudden increase in activity level
• Improper footwear with inadequate arch support
• Standing or walking for prolonged periods
• Repetitive impact exercises like running

Risk Factors

Certain factors can increase susceptibility to plantar fasciitis and heel pain:

• Obesity
• jobs requiring extended standing/walking like teachers or factory workers
• High arches
• Age - people between 40-60 at highest risk
• Athletes involved in running sports
• Flat feet or overpronation
• Tight Achilles tendons or calf muscles

Getting a Plantar Fasciitis Diagnosis

To confirm a diagnosis of plantar fasciitis, a podiatrist or orthopedic surgeon will conduct a physical examination of the foot, evaluating factors like:

• Precise location of pain/tenderness in heel area
• Presence of swelling, bruising, or redness
• Muscle tightness in the calves
• Arch height and foot mechanics during standing/walking
• Range of motion in the foot and ankle

The doctor may also order imaging tests like x-ray or MRI to help differentiate the heel pain from other possible problems like stress fractures, bone spurs, or nerve issues.

Plantar Fasciitis vs. Heel Spurs

Heel spurs often get blamed as the cause of morning heel pain, but this is usually incorrect. A heel spur is simply an abnormal bone growth on the bottom of the heel bone, and does not directly cause discomfort. However, plantar fasciitis can lead to bone spur formation over time as a secondary effect.

Treating Morning Heel Pain from Plantar Fasciitis

Treatment guidelines for plantar fasciitis focus on relieving inflammation, correcting any foot biomechanical dysfunction, stretching and strengthening foot muscles, and offloading pressure on the heel. A combination approach utilizing multiple strategies works best for most patients.

Home Remedies

Useful home treatments for reducing morning heel pain include:

• Over-the-counter anti-inflammatory medication like ibuprofen
• Ice packs applied to the painful heel area
• Night splints keeping the plantar fascia gently stretched overnight
• Heel cushions or orthotic inserts taking pressure off the heel
• Stretching exercises especially for the calf muscles and plantar fascia
• Rest and avoiding walking barefoot

Medical Treatments

If home care is not providing sufficient relief, a doctor may recommend:

• Physical therapy targeting affected foot muscles and alignment
• Taping or strapping techniques to support the foot arches
• Custom orthotic devices correcting overpronation or arch problems
• Cortisone injections reducing severe inflammation and pain
• Extracorporeal shockwave therapy applying sound waves to promote healing
• Medications like oral anti-inflammatories, muscle relaxants or analgesics
• Walking cast immobilizing the foot to rest the fascia

Surgery

In the small percentage of patients with chronic plantar fasciitis that does not improve with nonsurgical methods, a procedure like endoscopic plantar fasciotomy may be considered. This involves surgically cutting a portion of the plantar fascia to release the tension and relieve pain.

Preventing Recurrence of Morning Heel Discomfort

After the initial pain and inflammation of plantar fasciitis subsides, it is essential to take proactive steps to prevent recurrence and re-injury. Recommendations include:

• Wearing supportive shoes with good cushioning
• Maintaining ideal weight to avoid overloading the feet
• Using orthotic inserts if needed for proper foot support
• Continuing calf and plantar fascia stretching
• Taping or bracing the arch if engaging in high impact activities
• Avoiding going barefoot on hard surfaces
• Limiting activities like running to prevent overuse
• Progressing activity levels gradually when resuming exercise

With some diligence about protecting the plantar fascia, recurrent problems can usually be avoided once the acute pain has been treated.

When to See a Doctor

People with the following symptoms should consult a podiatrist or orthopedic foot specialist for evaluation:

• Heel pain lasting over 6 weeks
• Pain severe enough to limit daily activities
• Other foot problems like flat feet or high arches
• Signs of nerve damage like tingling/burning
• Prior history of foot fractures or surgery

While mild heel pain often resolves with rest and home care, seeking professional diagnosis is key to identifying any underlying conditions and getting personalized treatment recommendations.

Coping with Recalcitrant Heel Discomfort

For the minority of people whose morning heel pain becomes a chronic issue, managing the frustrating symptoms is an ongoing challenge requiring perseverance. Helpful coping strategies include:

• Being patient - recovery can take 6-12 months
• Adapting activities to reduce strain on feet
• Alternating sitting and standing at work
• Wearing shoes and orthotics all the time
• Trying pain relief modalities like massage, taping, ice, stretching
• Avoiding going barefoot as much as possible
• Keeping active to promote circulation and healing
• Maintaining a healthy weight

While chronic plantar fasciitis can be disheartening, staying optimistic and working closely with your podiatrist can eventually help get symptoms under control.

Outlook for Morning Foot Discomfort

With appropriate treatment, the prognosis for most cases of plantar fasciitis is good. About 80% of patients will experience significant improvement within 6-12 months. However, the condition can become chronic and recur periodically without proper prevention. Focused stretching, arch support, weight management, and activity modifications are key to minimizing episodes of morning heel pain.

Waking up with pain and discomfort in the heels is certainly no fun, but understanding the common causes and treatments empowers sufferers to take control. With some consistency following expert advice, those first steps in the morning can go from ouch! to ahhh....

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.