Why is my first step out of bed so painful? My heel really hurts first thing in the morning.
Heel pain may be an age-old problem, but it’s comforting to know that it’s not necessarily a sign of aging and it is treatable. It is generally the result of walking abnormalities that place too much stress on the heel bone and the soft tissues that attach to it. The stress also may be the result of an injury or a bruise incurred while walking, running or jumping on hard surfaces, wearing poorly constructed footwear or simply gaining weight.
Your physician will likely want to perform diagnostic tests to rule out problems of the bone. Early treatment also may involve anti-inflammatory medication, exercise and shoe recommendations or the use of orthotic devices (custom shoe inserts). These methods will most often effectively treat the majority of heel and arch pain without the need for surgery. Only a relatively few cases of heel pain require more advanced treatments or surgery.
If your heel pain is the result of injury or stress, you may have plantar fasciitis (fash-eye-tis). Although another culprit to consider is what’s known as heel spur syndrome, also a very common problem. In fact, up to 11 percent of the adult population has heel spurs that they are not even aware of and 73 percent of the adult population that has heel pain have a bony prominence associated with the pain.
The most common symptoms observed in both plantar fasciitis and heel spur syndrome are sharp, unremitting pain on the bottom, middle (arch side) of the heel where this thick fascia inserts. Other common sensations may be burning or throbbing pain in the same area. The greatest pain for these patients is usually the first step out of bed in the morning. As the day progresses, the pain usually lessens but does not go away completely. However, for patients who are on their feet a lot or are very active, the pain could actually worsen throughout the day.
If pain and/or other signs of inflammation such as redness, swelling and/or heat persist, you should definitely limit normal daily activities and contact your podiatrist immediately.
Dr. David Andreone is a board-certified podiatrist, a physician who specializes in the treatment and surgery of the foot at UT Health North Campus Tyler. For more information or to make an appointment, email his clinic at FootDoctor@uthct.edu or call 903-877-7826.