Q. When I wake up in the morning and first get out of bed I have severe pain under my heel. It gets a little better as the day goes on but never goes away. What is it and what should I do?
A. It sounds as though you have developed either Plantar Fasciitis or a Heel Spur Syndrome.

The arch muscles of your foot attach to the heel through a thick band of fibrous tissue called the plantar fascia. Heel Pain Syndromes are very common and can be either from irritation of the plantar fascia (Plantar Fasciitis) or it can actually be from the development of a heel spur at the plantar fascia attachment site (Heel Spur Syndrome).

Plantar Fasciitis is perhaps the most common injury that runners get. In non-runners heel pain is also very common and can be triggered by change in shoewear. Even if there is a heel spur, surgery is rarely ever needed. Most respond to a program of the following: supportive shoewear with good arch control (i.e. sneaker); gel pad for the heel area; the use of ice massage and Motrin or other NSAID; calf and arch stretching 5 to 10 times a day. One of the most affective treatments is the use of a “night splint”.

Your doctor can check for other causes of heel pain such as a pinched nerve, or stress fracture. For those stubborn cases, injections can be helpful and there are even newer non-invasive treatments using ultrasonic type sound waves.