heel pain

Q: I am suffering from a peculiar problem. Both my heel region of foot is paining severely. The problem is acute when I get up from bed in the morning after sleep. I can not walk properly for 2/3 minutes. Both my heels, with adjoinig foot region except toe, becomes rigid and gives immense pain at that time. The intense pain subsides after 7/8 minutes of walkin but small amount of pain remain in the hill region throughout the day. I think it is ORTHOSCLEROSIS. Doctors can not diagnose properly as nothing comes out concretly in X-ray. Kindly help me to get rid of this problem. Thank you.

A:Your symptom, seem to be because of plantar fascitis. Plantar fascia is a tissue, which is like a sheet, which separates muscle from skin. In some patients who have arthritis, this sheet of tissue gets inflamed and causes pain. In some patients, this could occur without any underlying arthritis. The exact reason as to why this occurs is not clearly understood. In some patients, this could be part of what is called as enthesiopathy where ligaments (structures that link bone tobone) and tendons (structures that link muscle to bone) become painful. X-rays are not diagnostic of the condition. The diagnosis is essentially clinical.Whatever be the underlying cause, the symptoms persist for a long time. Some times, may last several months. Simple analgesics may work in some cases where as patient may be incapacitated by pain despite painkillers. In such cases, local injection of steroids have been shown to be effective. However, since there is potential risk of infection with steroids, this injection, given at the site of maximum pain, should be given under strict aseptic precaution. If there is no relief, or only partial relief these injections may be repeated after 3 weeks. Normally, we do not give more than 3 injections.I think, you could double check with an Orthopaedic surgeon regarding your symptoms and proceed with treatment.

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