Have you ever gotten up from a chair or out of bed in the morning, and upon taking that first step, feel like your heel has stepped on a tack? Many people experience a feeling of sharp pain which radiates into their arch from their heel and does not allow them to put their heel on the floor. Sometimes they need to sit back down, stand only on their toes and use the wall for balance. If you can take a few steps, it seems to go away and lessens, allowing you then to resume your activity. Later, throughout your day and after a period of rest, it can happen again. If this sounds familiar you may be suffering from your first attack of heel pain, commonly associated with heel spurs.

A heel spur is an elongation or growth of your normal heel bone being pulled by its ligament, called the plantar fascia. The heel spur is a change in shape of your normal bone. We call this elongation or change a "heel spur". Since your heel is composed of spongy bone called cancellous bone, it reacts to stress and your body weight. The reaction of your foot is not only based on how much you weigh but it is how your heel hits the ground while trying to balance your weight. 

Plantar Fascia: The plantar fascia is the long ligament on the bottom of your foot under your arch.  Its attachments are from the bottom of your heel along your arch, into your toe area.

When this ligament doesn't get enough support, it stretches or pulls. In fact, it can actually sprain and we term this "plantar fasciitis".

Causes: Most commonly, we find that people who wear non-supportive shoes like sandals or flip flops and go barefoot get these symptoms. Because there isn't support under the fascia or arch of your foot, the ligament pulls excessively on your heel and causes the heel bone to change shape over an extended period of time.

However, you can also get these symptoms from an injury such as jumping off a ladder, a pick-up truck or uneven surface. People who do repetitive exercises such as treadmill, running or walking can get heel pain and/or plantar fasciitis.

Self Treatment: To treat the condition, initially it is best to get your foot into the most supportive tie-shoe you own, such as good jogging or walking shoes. Do not go sock- or bare-footed, not even in your house. Wearing appropriate shoes will allow for proper support of your heel and your plantar fascia and possibly decrease or lessen some of your symptoms.

You can decrease some of the heel and arch pain by putting an ice pack on your heel and arch for 5-8 minutes several times a day. You can then stretch your foot by bending it at your ankle, toes pointing up, and holding that position for 1 minute; do 5-10 repetitions to stretch the plantar fascia.

Those who are able can take over-the-counter anti-inflammatory drugs like Motrin or Aleve (but read the precautions and warning labels for health risks). However, some people should not be taking these medications or combine these type of medications with their prescriptions. If you have any questions, call your doctor who prescribed the medication.

If the pain persists, it is best to make an appointment with your podiatrist to evaluate your foot pain symptoms.

Initially there will be an exam of your feet, ankles and gait (the way your walk). There should be X-rays of your feet to see if the heel bone has a heel spur or if you are suffering from plantar fasciitis or other bone deformities.

You should bring in the shoe you wear most of the time so evaluation of your wear pattern can be assessed. This helps make a determination if your heel strike or the way you walk is normal.

After evaluation, a specific shoe may be prescribed for your activity, a night splint for resting periods, physical therapy to aid in strengthening and stretching, and/or orthotic control to balance your foot. If your symptoms are of a chronic nature such as over six months, it may warrant more diagnostic testing such as MRI, bone scan and ultra sounds.  Other treatments include ultrasound guided ablation of inflammed tissue, called Tenex, platelet rich plasma transfer and surgery.

What Else Can It Be? There are many causes of heel pain other than spurs and plantar fasciitis. If you have back, hip or knee pain, you can get heel pain. If you have a nerve entrapment in your ankle, called tarsal tunnel, you can get heel pain; if you have a metabolic disease such as arthritis, diabetes or circulation disorders, you can get heel pain. The diagnosis can be complex and will require your doctor to fully evaluate your medical history.

If you try some simple treatments and they fail to alleviate your heel pain, make an appointment with your foot doctor for further assessment. Foot pain is not normal. Take a step in the right direction and put a healthy foot forward.