Plantar Fasciitis and Heel Pain Treatment in Margao, Goa

Pain underneath your heel or along the arch of your foot can make the first few steps in the morning surprisingly painful. If the pain becomes worse when you stand or walk for long periods, or keeps returning despite rest and changes in footwear, it may be related to plantar fasciitis.

At Healthy Bones and Joints Clinic, Dr. Amol Narkhede makes the initial diagnosis and advises on medication where needed, and Dr. Rucha Narkhede guides the exercise programme that most treatment depends on. Treatment is usually focused on relieving pain, reducing stress on the plantar fascia and gradually restoring normal foot function rather than rushing toward invasive treatment.

The plantar fascia is a strong band of tissue running along the bottom of the foot, connecting the heel area toward the base of the toes. It helps support the arch and absorbs forces as you walk.

Plantar fasciitis occurs when this tissue becomes painful, commonly around the heel and arch of the foot. It can develop gradually and is often associated with repeated loading of the foot.

It is common in runners, but it is not only a sports injury: people who stand or walk for long periods at work, or who have recently become more active, are also affected.

An X-ray sometimes shows a small bony spur on the heel. Many people have heel spurs without any pain, and the spur is not what causes plantar fasciitis pain, so treatment is aimed at the plantar fascia rather than the spur.

The most characteristic symptom is pain underneath the foot, particularly around the heel or arch.

You may notice:

• Sharp pain when taking your first steps after waking up
• Heel pain after sitting or resting for a period of time
• Pain that eases after moving around but returns after prolonged walking or standing
• Pain during running or other high-impact activities
• Tenderness around the heel
• Pain when stretching the sole of the foot or raising the toes
• Increasing discomfort after spending a long time on your feet

The pattern of pain is important because several different conditions can cause heel pain.

Plantar fasciitis does not always have one identifiable cause. It can develop when the plantar fascia is repeatedly loaded beyond what it is accustomed to.

Factors that can contribute include:

• Increasing walking, running or exercise suddenly
• Spending long periods standing or walking
• Exercising on hard surfaces
• Tight calf muscles
• Footwear with inadequate cushioning or support
• Walking barefoot on hard surfaces
• Changes in activity level
• Being overweight
• Age-related changes in the tissues of the foot

People who suddenly increase their physical activity may be particularly susceptible to developing symptoms.

Diagnosis is usually based on your symptoms and a physical examination.

Dr. Amol Narkhede can assess where the pain is located, when it occurs, how the foot and ankle move, and whether the symptoms are consistent with plantar fasciitis or another cause of heel pain.

Imaging is not automatically required for every patient. If the symptoms are unusual, persistent, associated with an injury, or suggest another condition, further investigation may be considered. If an X-ray is needed, digital radiography is available on the same floor as the consultation rooms.

This distinction is important because heel pain is not always plantar fasciitis. A proper assessment helps determine the appropriate treatment rather than treating every type of heel pain in the same way.

When heel pain may be something else

These signs point away from plantar fasciitis and need a closer look:

• Tingling, numbness or burning in the foot
• Pain that began with a fall or injury, or after a sharp rise in running or walking
• Pain at night or at rest
• Swelling, redness or warmth around the heel
• Pain in both heels together with pain or stiffness in other joints

Most cases are initially managed without surgery. Treatment generally focuses on reducing irritation of the plantar fascia while progressively improving the strength and flexibility of the foot and lower leg.

Activity Modification

You may need to temporarily reduce activities that repeatedly aggravate the heel, particularly prolonged standing, walking or high-impact exercise.

This does not necessarily mean complete rest. The aim is usually to reduce excessive loading while maintaining appropriate movement and gradually returning to normal activity.

Footwear and Arch Support

Supportive footwear with appropriate cushioning can reduce discomfort during walking.

Heel pads or insoles may also be useful for some patients. Walking barefoot on hard surfaces and wearing footwear that provides little support may aggravate symptoms.

Stretching and Exercise

Stretching the calf and the tissues around the foot can be an important part of treatment. Progressive exercises may also help improve the strength and ability of the foot and ankle to tolerate everyday activity.

A physiotherapist can assess movement and guide you through exercises appropriate for your symptoms rather than simply giving a generic exercise programme.

Pain Relief and Medication

Dr. Amol Narkhede may advise pain-relieving medication for a short period where it is suitable for you. An ice pack wrapped in a cloth, held on the heel for up to 20 minutes, can also ease pain after a long day on your feet. Medication eases the pain while the exercises and footwear changes take effect.

Night Splints and Taping

When the first steps in the morning are the worst, a night splint that holds the foot gently stretched during sleep may be suggested. Taping the foot can give short-term relief during the day.

If the Pain Does Not Settle

Most people improve with these measures, although it can take several months. If heel pain continues despite a consistent programme, Dr. Amol Narkhede can review the diagnosis and discuss further options, such as an injection or shockwave therapy. Steroid injections can relieve pain but are used cautiously, because they may weaken the plantar fascia. Surgery is rarely needed and is generally considered only when about 12 months of non-surgical treatment has not helped.

Plantar fasciitis is treated mainly through exercise, so physiotherapy is the centre of care at Healthy Bones and Joints Clinic. Dr. Rucha Narkhede (PT), consultant physiotherapist (orthopaedics and sports) with 15 years of experience, practises independently at the same clinic.

She assesses how your foot, ankle and calf move, then teaches stretching and strengthening exercises suited to your symptoms and daily routine, and progresses them as the heel settles.

While she teaches each exercise and you perform it, she records it on your own phone. You leave with your own video of the correct technique, so you can follow the same programme at home between sessions.

Arrange an assessment if:

• Heel pain has not improved after about two weeks of rest, better footwear and stretching
• The pain is severe or stops you from working, walking or exercising
• The pain is getting worse or keeps coming back
• You have tingling or loss of feeling in your foot
• You have diabetes and foot pain

Seek urgent medical care if you cannot put weight on the foot after an injury, or if the heel becomes hot, red and swollen, especially with a fever.

For heel pain, contact Healthy Bones and Joints Clinic by phone or WhatsApp to enquire about a consultation.

Your first visit is with Dr. Amol Narkhede. He listens to your concerns, examines the foot and arranges an X-ray on the same floor if one is needed. He then explains the diagnosis, advises on footwear and activity, and prescribes medication if it is appropriate.

Physiotherapy then continues with Dr. Rucha Narkhede at the same clinic. If the pain does not settle as expected, Dr. Amol reviews it again.

Both practitioners generally practise during the clinic’s operating hours, subject to individual availability. Dr. Amol’s schedule may vary when he is undertaking surgery, so contact the clinic before visiting.