Surviving COVID-19

Heel pain

Surviving COVID-19 without my Podiatrist

Welcome quarantined foot sufferers to my blog series where I will provide at home self-help guidance to common foot ailments. I will cover a different condition during each installment.

The information provided in our articles is not intended as medical diagnosis or care. However I do hope it can help the reader be able to take better care of the unsung heroes of our body, our feet.

If you have any questions about any of the topics covered, as well as any other subject not being addressed, please email me at drreyes@ngfootcare.com.

Heel Pain

Perhaps the one of the most common conditions I see in my practice is heel pain. Heel pain is one of those conditions that doesn’t affect a certain type of patient. Tall, short, fat and skinny patients alike can suffer from heel pain. There is no preference between men or women for this condition. The reason being that the heel bears most of the weight bearing stress when we walk. Therefore, it is very susceptible to vascular, neurological, arthritic and even minor traumatic changes during daily activities. These changes are influence by a person’s foot type ( flat feet/ high arched), medical conditions ( diabetes, PAD, herniated discs, etc.) and lifestyle changes (weight gain, working on your feet,etc).The two most common conditions leading to heel pain are plantar fasciitis and heel spurs.

Plantar Fasciitis

Plantar fasciitis is an inflammation of a thick ligament that runs from the heel to the ball of the foot. The main function of this ligament is to hold up the muscles and tendons of the bottom of our feet. It also helps shape our arches. The plantar fascia is a very elastic structure, allowing our feet to absorb shock when we walk. The main symptom of plantar fasciitis is acute pain when first stepping out of bed in the morning. This is due to the fact that the “sore” ligament which is contracted, is now forced to stretch when weight bearing. The pain gets a little better after patient walks on it for a while.

Now in a perfect world, you would make an appointment with your friendly neighborhood podiatrist and seek relief. Unfortunately, these are not normal times. So what can you do at home for temporary relief?

First please note that this condition doesn’t usually respond to over the counter anti inflammatory medicines such as Advil or Tylenol. The main idea here is to promote stretching and local pain relief to the area. You need to decrease inflammation to the area, while promoting stretching of the tissue. The easiest way to do this is by doing a little at home physical therapy. Take an unopened bottle of water and freeze it.

Plantar Fascia explained
An Illustration of a Plantar Fasciitis

While sitting on a chair, place the frozen water bottle on the floor and roll it on the bottom of the affected foot, from the heel all the way to the forefoot area. Do this every day for 5 minutes.

You can also order an over the counter insert from (amazon, Wal-Mart etc.) that covers the entire foot. I recommend the Dr.Scholl extra support massaging gel inserts. They are easy to find and are usually no more than $12.95. Now the trick to using inserts is to first remove whatever inserts your shoes bring before putting them in. Otherwise, they become very uncomfortable to wear. You must also try to avoid wearing flat shoes or sandals during this time. The ideal shoes to wear with the inserts are athletic sneakers. It can usually take a good 10-14 days before your condition improves. If you notice that the pain increases or there is any kind of swelling or change of color to your foot after starting this regimen, you must stop immediately and seek medical care.

Illustration of Heel Pain including Heel Spur and Plantar Fascia
Illustration of a Heel Spur

Heel Spurs

So what is the difference between a heel spur and plantar fasciitis? A heel spur is a bony growth on the bottom of the heel. It is formed by tiny calcium deposits on the heel bone. Chronic plantar fasciitis leads to the formation of heels spurs.

Heel spurs form because the fascia is pulling against its origin on the bottom of the heel. The heel spur can also produce the “morning pain” like the plantar fasciitis.  So how can you distinguish one from the other? The key difference between the two is in the location of the pain. Heel spurs produce pain on the center of the heel, while plantar fasciitis produces pain in the arch area.  How can you relieve the heel spur pain for a quarantined foot?

The heel spur is considered an arthritic process so it can respond well to over the counter anti-inflammatories such as Advil, Motrin, and Naprosyn etc. This is, if you don’t have any medical contraindications not allowing you take these Medications. Usually it is advised that a patient take the OTC as directed for pain for at least two days.

However, what can you do if you can’t take oral anti-inflammatory? You will need to do two things!

I recommend Aspercreme Lidocaine XL patches. They are sold over the counter as a large patch to be used for back pain. They can be cut up into smaller sizes. Place the patch on the arch side of the heel and put on a cotton sock in order to keep it in place. You can put one on every twelve hours for 7 days. This will help reduce the pain. Second, the heel needs to be iced every day for 5 minutes.  Place an ice pack, covered with a towel, on the arch side of the heel. You must follow the same shoe wear restrictions as with the plantar fasciitis. Heel spurs require an insert that can create support and remove direct weight bearing stress from the spur. I recommend the Dr. Scholl’s Heel Pain Inserts (Amazon, Wal-Mart, etc.).

They are very easy to find and cost no more than $8.95. You must remove your shoe’s original inserts before putting them in your closed shoe, preferable sneakers.  This condition can take up to 14 days to improve. If you notice that the pain increases or there is any kind of swelling, or change of color in your foot, you must stop this regimen and seek immediate medical attention.

 Finally, these remedies are not expected to completely resolve your heel pain. They are safe ways to achieve some relief during the pandemic until you are able to see your podiatrist.

Stay safe!