Inferior heel pain worst in the morning, pain and tenderness most around medial calcaneal tuberosity, usually unilateral, more in the obese and in peope whostand for long periods on hard floors, or run long distances. Therapy can be frustrating but if started early in the course of the disease, much can be done.
Treatment
Advised not to walk bare feet.
Oral anti-inflammatory drugs like ibuprofen, or Naproxy. Withdraw as acute pain subsides
To wear shoe supports that have arch suppots and soft heels (‘microsolve fittled’) old shoes can aggravate the problem. Laced sports shoes are better than sandals.
Topical NSAIDs are useful.
Gastrocnemius New Delhi soleus stretching exrcises i.e. passively dorsi-flexing the foot while keeping knee extended, flexing the knee when dorsi-flexing the foot. (see appendix)
In refractory cases, local injection of lignocaine plus corticosteroid, preferably in the tender medial aspect rather than inferiorly.
Surgery in cases with intractable pain and the measures include release of plantar fascia, calcaneal spur excision, and endoscopic procedures.
