Q: I am a 26 years old man have been plagued with mild pain from the last few months at the arch/sole of the foot. It is around the area where talus is located and also around calcaneus. Though the pain is bearable and it has been there for long time but now it disturbs me. Please help.

A:From your description you seem to have plantar fasciitis. This is a condition that comes without any obvious reason but comes in the category of what are known as enthesitis where there is pain at the catchments of ligaments and tendons. The reason why it happens is not known but if the patient has such a pain we try to look for conditions that can present with joint pains like ankylosing spondylitis and other such conditions. It may also be seen in patients with inflammatory bowel disease (they present with loose motions). Some patients may be found to have high uric acid levels in the blood (may just be an association) while others may be found to have low functioning of thyroid. But most often no obvious cause is found. But the treating physician must examine for all these associations. Treatment is empirical with simple anti-inflammatory medicines like Ibuprofen, Diclofenac Sodium, etc. Earlier persistent cases were given local steroid injections. This must not be taken lightly and as far as possible must be avoided as there are some reports of infection (before injection diabetes has to be excluded, and injections must always be under strict aseptic conditions in the operation theatre). I always try to avoid these as there are also reports of atrophy of heel pad which may have long term consequences. Though the condition has nuisance value, best is to hope that it will settle in due course of time (which it does – from months to occasionally over a year and it does not lead to any permanent problem). Best to avoid walking bare foot and wear hawaii chappals at home and have a soft heel cup in your outside-home foot wear.