Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (1)

An unusual cause of plantar fasciitis

Good medical diagnosis and treatment often requires some detective work.  One of my patients came to see me for foot pain recently.  She described what sounded like a pretty typical case of plantar fasciitis – pain in the heel of her foot, worst with the first few steps in the morning, improving throughout the day.  I recommended stretches, physical therapy, night splints, ibuprofen… but to my surprise nothing was really helping.

One wintery day she came back on a return visit and I happened to notice her footwear – boots with a very thin, flexible sole.  Slowly I began to think of her tromping over ice, sand, gravel, and snow in these boots…  I asked her if she could feel the ground under her feet.

“Yes, I can feel everything – I don’t like to walk around in the snow and ice because it kind of hurts to step on all the lumps and bumps.  But I can’t just stay indoors all day, I have errands to run!”

I explained to my patient that I had a hunch that the rocks were bruising her plantar fascia, causing it to be inflamed and painful.  I asked her to buy herself some thick soled boots – the kind where she couldn’t feel the lumps and bumps under her feet.

About a week later my patient called to tell me that her foot pain was much better.  The new boots seemed to be doing the trick…  “I never knew why my plantar fasciitis got worse in the winter times, doc.  I thought it was the cold that made things worse.”

Well, I had learned a lot too… sometimes the best treatment option is not on the standard protocol list.  The power of observation is one of a physician’s most important weapons.

This post originally appeared on Dr. Val’s blog at

You may also like these posts

Read comments »

One Response to “An unusual cause of plantar fasciitis”

  1. Anonymous says:

    I was very pleased to read about how you were able to help your patient by taking the time not only to listen to her, but to observe her footwear and draw conclusions that finally solved the problem of her plantar fasciitis. Keep up the good work, doc!

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »