Question: I am 63 years old and walk 2 1/2 miles a day. Recently I've been getting a pain under my heel after walking only a few blocks. My feet are in good condition, and I have no bunions or corns. What causes this, and what can be done about it?
Answer: Heel pain can be divided into two types. The first is pain associated with general arthritic illness or disease. This type usually occurs in younger people, particularly men, though it can be an early symptom of arthritis at any age. If your other joints are also a problem (hand, shoulder, wrist), we recommend contacting your physician for a referral to a rheumatologist, who can determine whether this is a local problem or a more generalized arthritis.
The second and most common type of heel pain is associated with a local problem that most often occurs under or on the sole side of the heel. It may be caused by plantar fascitis, an irritation that occurs where the ligaments and small muscles of the foot originate on the heel bone. Plantar fascitis is sometimes associated with a heel spur (bony growth on the bottom of the heel bone). Another problem that can cause heel pain is too thin a fat pad cushioning the heel bone.
Treatment of local heel problems should begin with assessment of your overall foot alignment and your shoes. For example, if you have a very high arch, you may be placing too much pressure on the heel.
Walking 2 1/2 miles per day is a significant distance, and this may not be practical using ordinary street shoes. A properly balanced walking shoe is helpful, one with a longitudinal arch support for more contact at the bottom of the foot. Commercially available arch supports can be purchased inexpensively in sporting-goods stores.
Q: My 87-year-old father was recently admitted to a nursing home. He's having difficulty sleeping, partly because he's used to his own bed. Since he has a private room, I asked about bringing in his bed from home and was refused. Why so, if it would ease his transition into the nursing home?
A: Most nursing homes don't allow residents to bring their own beds. According to the American Health Care Assn., almost all nursing homes use hospital-type beds that can be adjusted to ease the resident's getting in and out of bed, and make patient care easier. These beds can be raised or lowered, and the positions adjusted.
A second consideration is that nursing homes must satisfy safety and health regulations that allow only certain kinds of beds in a nursing facility. Most home mattresses are not fireproof, and many times hygienic standards required by law have not been met at home. In time, your father will probably adjust to his new bed. If his sleeplessness persists, consult with his physician about possible physical or mental difficulties or medication side effects that may contribute to the problem.