Heel pain in the morning can be particularly frustrating for active patients or those working toward weight loss goals
Aside from back or neck pain, foot pain is one of the more common conditions that chiropractors treat. In many ways, properly treating foot pain can ease many other issues, including ankle, knee, and hip pain. Additionally, foot problems are far more common than most people think. In a 2018 survey of 1,000 US adults, the American Podiatric Medical Association found out that almost 77% of respondents were dealing with some type of foot issue, most commonly heel pain from bone spurs or plantar fasciitis. This includes patients suffering from heel pain in the morning.
Furthermore, 83% of survey respondents reported their pain as excruciating, and more than half stated that their pain had severely restricted their activities or adversely affected their balance. Despite the staggering number of survey respondents with foot issues, only one third said that they were considering seeking professional medical help to alleviate their pain.
What can cause heel pain, what are some of the more common treatments, and how do orthotics measure up against those treatments?
Causes and standard treatments for heel pain in the morning
Heel pain in the morning could be from a host of conditions including plantar fasciitis, Achilles tendinitis, or an injury like a stress fracture. There can be a number of different causes for heel pain from bone spurs, genetics, obesity, or chronic conditions affecting the joints, such as arthritis.1
Standard, nonsurgical treatment other than orthotics will often involve stretching exercises, physical therapy, hot or cold treatments, splints, NSAIDs for pain relief, or steroid injections into the affected areas. In most cases, surgery is not a consideration until standard treatments haven’t provided relief after 9-12 months.
The case for orthotics
A 2015 review article in the Chinese Journal of Traumatology provided a roundup of the various nonsurgical and surgical options for treating heel pain – most commonly, plantar fasciitis and bone spurs.1
In looking at various treatment options, the researchers considered surgery to be the last option, when all others had failed. However, they considered orthotics to be one of the best nonsurgical treatment options, alongside rest, ice, and stretching exercises. Furthermore, orthotics can also serve to prevent recurrence of heel pain.1
Another article from the same year, published in the Journal of the Oklahoma State Medical Association, compared the use of orthotics to other nonsurgical interventions in cases of acute, symptomatic plantar fasciitis.2 The authors noted that a second line of nonsurgical treatment may be considered when NSAIDs and stretching do not provide relief. Such treatments can include cortisone injections, physical therapy, and chiropractic manipulation.
Furthermore, orthotics provided additional benefit within 1-3 months, with little to no additional risk.2
Orthotics use over the short and long term
A 2018 article in the British Journal of Sports Medicine reported results from a meta-analysis to determine the effect of orthotics for improving pain and function from plantar fasciitis over the short- (0-6 weeks), medium- (7-12 weeks) or long-term (13-52 weeks) duration.3 For this type of study, the researchers analyzed results from 19 papers, which represented 1,660 individual participants, to look for common patterns among the findings. Over the medium-term duration, there was moderate-quality evidence showing that orthotics were beneficial for reducing heel pain in the morning and general foot pain. Although more research is needed to determine if orthotics could be useful over longer periods of time, the researchers were encouraged by their findings.3
Heel pain in the morning arising from plantar fasciitis or bone spurs can be particularly frustrating for your active patients or those who are working toward weight loss goals. Fortunately, foot orthotics, particularly when combined with other noninvasive treatments, can provide the kind of relief that will allow patients to stand up against heel pain.
- Agyekum EK, Ma K. Heel pain: A systematic review. Chinese Journal of Traumatology. 2015;18(3):164-169.
- Lewis RD, Wright P, McCarthy LH. Orthotics compared to conventional therapy and other non-surgical treatments for plantar fasciitis. Journal of the Oklahoma State Medical Association. 2015;108(12):596-598.
- Whittaker GA, Munteanu SE, Menz HB, et al. Foot orthoses for plantar heel pain: A systematic review and meta-analysis. British Journal of Sports Medicine. 2018;52(5):322-328.