Why Does My Body Hurt Series: Why Do My Heels Hurt?

Foot and heel pain is one of the most common complaints from nurses, and with long shifts requiring constant walking and standing, it’s no wonder why. Foot pain can be the difference between feeling focused and confident while treating patients or watching the clock in agony waiting for the shift to end. When working 8 to 12-hour shifts, it can be extremely difficult to give your feet and heels the rest they need to recuperate between sessions. Because of this limited time, understanding exactly what causes the pain and the most effective ways to alleviate it is important to “hit the nail on the head” and avoid wasting days trial and erroring different solutions.

Plantar Fasciitis – What is it?

One of the most common causes of foot pain for nurses is plantar fasciitis, which is an overuse injury of the foot. Technically, what’s going on here the ligament that connects from the heel to the front of the toes (the plantar fascia) is becoming overused to the point of accumulating small tears. These small tears lead to inflammation, tenderness, and what can be severe pain. A common symptom of this is a stabbing sensation felt in the sole of the foot. You naturally put pressure on this ligament when walking, so it makes sense that nurses who spend hours on end walking around the hospital would be at especially high risk for this condition. Heel pain is often misdiagnosed as heel spurs when in reality it is plantar fasciitis.

How Do You Prevent Plantar Fasciitis?

If you are lucky enough to have avoided developing plantar fasciitis—or you are in the early stages—prevention is key. Choosing the right pair of shoes can save you years of agony. You need to wear shoes that provide support, especially to the arch of the foot, and that are heavily cushioned. Resting the feet between shifts is also key to letting “almost tears” heal before the stress on this ligament accumulates too high. In addition to this, barefoot running should be avoided as it can aggravate the plantar fascia and increase pain.

How Do You Treat Plantar Fasciitis?

Sometimes, there’s no way to avoid tearing the plantar fascia. If this happens, don’t fret – we’ve compiled a few of the most effective options that can provide relief.

Rest, Rest, Rest

This may seem like an annoying line of treatment, especially when your job (and probably life in general) requires you to be on the go, but it is sooo important for a pain-free future. Giving yourself a few days to avoid any high-impact activities and stay as stationary as possible can help inflammation settle and pain subside. This is without a doubt the most effective home treatment for foot and heel pain caused by plantar fasciitis and it should be taken seriously. As plantar fasciitis progresses, it only gets harder and takes longer to relieve pain.

Physical Therapy

Therapeutic exercises are another great way to treat the root of the problem and help heal the plantar fascia. Meeting with a skilled physical therapist, even just one time, can give you the tools you need to combat existing pain and prevent further progression. The physical therapist can assess your current condition and give you exercises that stretch and strengthen the plantar fascia, along with surrounding tissue such as the Achilles tendon and lower leg muscles.

When you discuss your pain with a physical therapist, they can also recommend additional therapies such as massages, baths, ultrasonography techniques, and types of shoes/inserts that can help moving forward.

NSAIDS or Steroid Injections

Taking non-steroidal anti-inflammatory medicines (NSAIDS) can be a great option to manage pain from plantar fasciitis. If you absolutely cannot take rest and need to quickly relieve pain, reducing the inflammation through taking NSAIDS can help provide temporary relief. However, unlike rest, this should not be treated as a solution to foot and heel pain, it is only a temporary helper.

Another method of pain relief is by directly injecting synthetic cortisone into the plantar fascia. This is a steroid injection and can reduce the inflammation in the area and subsequently reduce pain. However, this treats the symptoms of plantar fasciitis, but it does not treat the root cause and should not be considered a stand-alone solution.

Orthotics and Splints

Wearing orthotics inside the shoe can help provide extra support for the arch of the foot. By having additional support to keep the natural arch position of the foot, the plantar fascia has to “do less work.” This reduces strain on the plantar fascia and reduces the risk of tears or additional tearing. We recommend visiting an orthopedist to have custom insoles fitted to your foot.

Splints are another great option for treatment. Splints are used to keep your food at a flexed angle and are typically worn at night. This takes the pressure off of the tears in your plantar fascia and can help promote healing.

Additional Tips to Relieve Foot and Heel Pain

Wear Compression Socks

Wearing compression socks can increase blood flow and oxygen to the foot by improving circulation. This reduces swelling and can help to calm irritation and pain.

Stretch Your Feet

Throughout the day, make sure you are stretching your feet (and the rest of your body while you’re at it). This can be done by facing a wall and placing the toes of one foot against the wall while the heel is on the ground, creating a flex of the foot. From here, gently bend the knee and lean into the wall, feeling a stretch along the bottom of the foot. Repeat on each side and try to do this a few times per shift and while at home.

Hot and Cold Water Therapy

At the end of a long shift, alternating soaking your feet in hot and cold water can help stimulate circulation and promote healing of the tissues in your feet. The alleviates swelling and reduces pain.

Epsom Salt Soak

Mix a cup of Epsom salt into a large bowl of warm water. If you have any on hand, add a few drops of essential oil such as peppermint, lavender, or eucalyptus. This helps to increase circulation and the magnesium and other minerals in the Epsom salt will help to calm inflammation and reduce swelling.

References

https://www.nurseregistry.com/blog/foot-problems-in-nurses/

https://www.ausmed.co.uk/cpd/articles/plantar-fasciitis