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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

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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!

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