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Had terrible foot problem. Excruciating after standing and limping. Noticed bubbles around heel. Suggest treatment to get relief?

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Orthopaedic Surgeon
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My wife (age 36) has had a terrible foot problem, for about 1 year now. She has seen a podiatrist who said it was plantar fasciitis. On putting any pressure on it, It becomes excruciating after any general standing, even on rising in the morning. It causes her to limp so badly. The podiatrist made orthortics for her about 6 months ago and she has worn these religiously, yet the condition is still the same. When you put some pressure around the heal area, you see little bubbles about 5mm diameter (I have noticed the same on my foot to some extent, but on my wife's affected heal it is about 20 times worse or more noticeable).

We were told to use my knuckles and 'push' on the underside of the foot, down from the ball to the heal. I've done this regularly for months now, but still no improvement.
Posted Mon, 4 Nov 2013 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 17 minutes later
Brief Answer:
Needs pain killers and local steroid injections.

Detailed Answer:
Thanks for posting your query.
The pain in heels is due to plantar fasciitis. Its one of the commonest reason for heel pain. Pain in morning is its classical presentation. The initial treatment is with anti inflammatory medicines with rest and cold fomentation works fine for most of the patients. Cortisone injection is a good mid to long term treatment. Your wife might need a repeat dose in a few months. Beware of not to take it frequently since it causes induced tear of plantar fascia. Consider using soft silicone heel cushions for preventing any further damage to fascia. You can get the necessary drugs prescribed from her orthopedician. A heel spur also needs to be ruled out after X-ray.

Exercises also play an important role and I'm afraid they are the only long term mainstay of the treatment. I'm sure you already know but these are few exercises she'll have to do for long time-

1. Calf stretch- Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.

2. Plantar fascia stretch- This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you in a controlled fashion. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot.

These exercises are best done in the morning before standing or walking. You also need to understand that with help of medicines, injections and physiotherapy the effects shall be appreciated after a few weeks or so.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: Had terrible foot problem. Excruciating after standing and limping. Noticed bubbles around heel. Suggest treatment to get relief? 42 hours later
Is exercise going to make it worse? She has gone to the gym this morning & I've suggested she only do cycling where the strap connected to the pedals allows upward force to be exerted rather than downward pressure. I also suggested sit-ups. What other cardio exercises can be done?
Answered by Dr. Praveen Tayal 5 hours later
Brief Answer:
She can also do swimming and aerobics.

Detailed Answer:
Thanks for writing again.
Initially she might feel some pain in dong exercise but regular exercise will help in decreasing the pain and other symptoms.
She can do cycling, sit ups, treadmill, circuit training, swimming, light aerobics, etc.
Hope my answer is helpful.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.
Above answer was peer-reviewed by
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