The most common cause of gradual onset heel pain is plantar fasciitis. People with plantar fasciitis usually feel pain in the inner side of the heel or arch of the foot. This pain is commonly felt with the first few steps right after you wake up in the morning and/or when you get up after sitting for a long time. As the day goes on pain usually gets better, but it can get worse by the end of the day especially if you are standing and walking a lot during the day.
Plantar fascia is a thick band that extends from the heel to the ball of the foot. The function of plantar fascia is to support the arch of the foot when it bears weight during weight bearing activities. Plantar fascia gets repeatedly elongated/pulled during the weight bearing phase of walking.
This repeated pulling on the plantar fascia during the weight bearing phase of walking, running or jumping might cause micro tears on the origin of the plantar fascia resulting in inflammation which may not heal and produce pain. Common causes of plantar fascia irritation leading to heel pain are prolonged standing, running, use of improper foot wear, flat foot or high arched foot, starting a new exercise routine like jogging, tight calf muscle or Achilles tendon etc.
People with plantar fasciitis feel pain in the heel in the first few steps after they wake up and after sitting, pain might get better after you take a few steps. You will notice some tenderness at the heel and or along the arch.
Diagnosis and management:-
Your family doctor or physiotherapist will be able to make a quick diagnosis as you describe your pain and the history of onset. Usually no imaging or test is required for diagnosis of plantar fasciitis. Your doctor might prescribe anti-inflammatories to manage the symptoms. Give your foot rest and cut down weight bearing or pain causing activities. Ice your heel for 10 -15mins 2-3 times a day. Do calf and toe stretches a few times a day.To relieve muscle tension and to stretch plantar fascia you can roll a small ball with the sole of your foot.
Consider seeing a physiotherapist to do some passive physiotherapy sessions and to get proper exercise instruction which will help in treating the condition and also to prevent it from recurring.
Use of proper foot wear with custom fitted orthotics will help in reducing the stress put on the affected tissues while weight bearing.
Shock wave therapy is also a good option for treating chronic plantar fasciitis that is not responding to NSAIDs, physiotherapy and orthotics before considering surgical intervention.
Your doctor will suggest getting a steroid shot if conservative management strategies are not working.
Tahriridian, M. A. ( 2012, August)Plantar Fasciitis. Retrieved from https://www.ncbi.nlm.nih.gov