On your feet

For relaxed feet: Best results come from exercise.

For relaxed feet: Best results come from exercise.   | Photo Credit: Photo: Bijoy Ghosh

What to do when you have to deal with painful feet first thing in the morning. DR. HIRAMALINI SESHADRI

Sita is fine throughout the day but the first few steps she takes when getting out of bed in the morning are so painful. The same thing happens if she sits for a few hours and gets up. What ails Sita and countless others is Plantar Fascitis, a common cause of foot pain.

Plantar fascia is the thick fibrous tissue that connects the tiny front bones of the foot with the heel bone or calcaneum at the back. It is virtually the anchor for all foot movements.


Overuse, which translates as too much of standing or walking, misuse like stuffing your feet into ill-fitting high-heeled shoes or being obese, genetic factors like flat feet or too high a foot arch as well as chronic arthritic conditions can set off plantar fascitis.

Patients usually seek help after two to three months of pain. Pain killers give only temporary respite and, in the long-term, their side-effects grossly outweigh benefits. Earlier local steroid injections into the heel were in vogue; but recent studies have shown that the ‘fascitis’, when studied under a microscope, shows more wear and tear rather than inflammation; so steroids may really not have a role.

So then what can you do? Cold compresses help. Strangely, soaking one’s feet first thing in the morning in warm concentrated salt water also helps like magic. The explanation is that it improves blood flow, which washes out pain and any tissue functions are better when blood supply is good. Ultrasound therapy, extra corporeal shockwave therapy, and acupuncture have been found to be beneficial.


Best results have come from exercise. Stretch exercises for the Achilles’ tendon and feet have uniformly benefited patients. Shedding weight, if obese, is crucial. Soft arch-supporting footwear helps if one has flat feet. Putting one’s feet up, especially if one has a job involving constant standing or sitting can be invaluable.

Can a heel spur cause such pain? They can but surprisingly heel spurs usually result from chronic plantar fascitis rather than being a cause of the fascitis. Of course once they form they add to the pain. It’s like stepping on a thorn as you walk.

The good news, however, is that the simple treatments outlined above help reduce spur pain too. If the foot pain is related to a primary arthritic problem, then proper diagnosis and management of the primary problem becomes mandatory.

The writer is a Senior Consultant, Holistic Internal Medicine and Rheumatology based in Chennai. E-mail: >

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