Walking too many miles in our own shoes is the leading cause of pain in the heel. A gait that exerts excessive stress on the heel bone and the plantar fascia (fibrous bands spanning the long arch of the foot) can produce pain and tenderness in the bottom of the heel. Discomfort can also result from poorly made shoes, obesity, a stress fracture of the heel bone, bruises of the fat pad under the heel, or a disease such as rheumatism or gout. Some heel pain is classified as idiopathic-- meaning its origin is unknown.

A sore heel may hurt the worst early in the day, feeling better as one walks it off. If this typical pattern occurs for a few days and then subsides, there's little cause for concern. However if, as in your friend's case, the discomfort lasts for weeks, it's important to contact a doctor. Heel pain can usually be treated successfully, but resolution is often slow. Wearing well-fitted shoes with soft, shock-absorbent soles is a good start. Orthotic devices may absorb some of the impact on the heels. If your friend is overweight, losing some extra pounds may help. Doctors also sometimes prescribe nonsteroidal anti-inflammatory drugs or similar medications, or suggest applying heat and/or cold to the heel.

If the sufferer is patient, the pain almost always disappears with time. On rare occasions, when severe heel pain does not respond to the above mentioned conservative measures, a brace or walking cast may be indicated. Surgery is definitely a last resort, used when all else fails. If your friend is worried about the prospect of surgery, it couldn't hurt for him/her to get a second opinion. Another doctor may have more patience, or more ideas for tactics to try before surgery is necessary. A second opinion can also be reassuring that the first opinion was right.

Alice

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