Dr. Nagaraj
Diabetology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
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Patient's Query
Hi doctor,
I have pain below my right heel when I wake up in the morning. I have this pain for the past month, and now the pain has increased.
Hello,
Welcome to icliniq.com.
Sorry to hear about your problem. Few questions to ask.
1. Is it only in one heel or both?
2. Is this pain a stabbing in nature?
3. Does it improve with walking?
4. Whether pain re-appears after you start walking or after prolonged rest?
5. Does it wake you up from sleep?
6. Are you diabetic? If yes, since when and is it in control?
7. What is your occupation (does it require you to stand for long hours)?
8. Do you wear shoes regularly or daily?
9. Is there any history of trauma to the leg or heel anytime?
Please let me know your answers to suggest accordingly. Take care. You need not pay for answering these.
Patient's Query
Hi doctor,
Thank you for your reply.
The pain only in one heel on the right side. The problem is there only when I put pressure on the right side while walking or standing. You can say it as a stabbing pain. When I wake up in the morning and take the first walk, the pain is there; then it reduces gradually. The pain is not there when I am resting. I do not feel anything; only when I walk, I can feel the pressure. I am not diabetic, and the pain does not wake me up from sleep.
My occupation makes me sit, stand, and walk. I do morning walks about four times a week, for one hour each day, and I cover 4 km, but because of the pain, I only walk for one day, then I do the next after two days rest. Except for weekends, I wear leather flat-heeled shoes daily.
I have no history of trauma.
Further for your information: I live alone and am self partnered; I have no help or servant in the house; I am very active; I walk, cook my breakfast, clean my house, wash dishes, drive myself to work, and take care of my garden, plus I put in about five to six hours of desk work daily (except weekends). But now this pain in the heel is bothering me a lot.
I am also enclosing my blood report. In case it is of any use.
Hi,
Welcome back to icliniq.com.
Fine, that helps. I think you missed attaching the reports. Anyways, going by history and complaints, it looks like you have "plantar fasciitis." In simple terms, it is nothing but the inflammation of a kind of sheet or tendon in the heel due to wear and tear. It is usually seen in people above 40 years of age. The best treatment for the same is pain killers and rests on your foot for a few days. Avoid prolonged standing or pressure on the heel. Avoid wearing shoes, especially ill fitting shoes.
The other lesser possibility is a bony outgrowth of the heel bone (in medical terms, Calcaneal spur). This can be confirmed by doing an x-ray of the foot. It will help me further if you can share the reports you missed attaching.
I am herewith sharing my prescription, which should reach you in the next 30 minutes. Let's review it after two weeks. I may make minor changes by looking at your blood reports. I hope this helps. Take care.
Patient's Query
Hi doctor,
Thank you for your reply.
I have sent you the blood report.
Hi,
Welcome back to icliniq.com.
The reports (attachment removed to protect patient identity) are normal for your age. I do not want to change my earlier prescription as serum Creatinine is normal.
I noticed that you are deficient in vitamin D. It is better to start supplements which help in overall well being. I am prescribing the same.
Capsule D-Rise 60K IU (Vitamin D supplement) once in a month for the next six months.
Also, note that pain in your heel may recur in the future. Pain killers are the only treatment at this stage. Let us review it after two weeks.
Take care.
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Diabetology
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