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Q. Please advise the best treatment for heel pain.

Answered by
Dr. Akshay Kumar Saxena
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 09, 2017

Hi doctor,

I have started getting heel pain after exerting in tennis. Please see the photo of the pain area marked in red. Initially, I had continuous pain while walking. It is slightly more on the first few steps after rest or sleep. My physiotherapist suggested it could be a plantar fasciitis and I am undergoing physiotherapy sessions. Had ultrasound and TENS, four sessions. Apart from that I am doing stretching exercise and ice pack at home. Hot water on foot did not help much. The pain is ongoing for 15 days and does not seem to be improving much. Please advise the best treatment options. Also, do you observe any calcification in the x-ray? I have attached my x-ray for your reference. How long will it take to heal?

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Hello,

Welcome to icliniq.com.

  • You have mentioned pain in the area of heel region, which has been marked by you and it looks like plantar fasciitis, which has already been mentioned to you.
  • Just let me know whether there are any other signs and symptoms of inflammation like skin redness, local warmth, any swelling or any other symptoms like fever, etc.
  • If there is none, then just let me know your uric acid levels if you have recently got them done.
  • In any case pain in the heel region if there are no other significant history of injury or any other symptoms is suggestive of plantar fasciitis for which the treatment is explained below. Consult your specialist doctor, discuss with him or her and take the treatment with consent.
  • The treatment is aimed at offloading the inflamed fascia, which is usually done by a proper footwear modification. Use silicon insoles and air heel, which is meant for plantar fascitis only.
  • Use of ice packs intensively for three to four times in a day for 10 to 15 minutes every time also helps in relieving inflammation.
  • You can also use an analgesic spray like Dynapar QPS spray (Diclofenac) for local application after fomentation.
  • Also, I suggest a gentle anti-inflammatory medication like tablet Durapain (combination of Diclofenac and Tramadol) one tablet twice a day or tablet Hifenac P (combination of Aceclofenac and Paracetamol) one tablet twice a day after meals for five to seven days.
  • As you have mentioned continue with your physical therapy modalities and add laser therapy if it is available.
  • Also, there is no significant calcification for you to worry in the x-rays as I have gone through your films (attachment removed to protect patient identity).
  • Please let me know after two to three weeks how you are feeling. If the pain does not decrease, then injections might have to be given to relieve inflammation.

The Probable causes:

Heel fascia Inflammation.

Regarding follow up:

Revert back after two to three weeks to an orthopaedician and traumatologist online.---> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist


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