What is the treatment for pain from the midfoot to the heel?

From the Guidelines

For pain from the midfoot to heel, I recommend starting with rest, ice, and over-the-counter pain relievers like ibuprofen or acetaminophen, as well as using open-backed shoes, heel lifts or orthoses, and stretching exercises as initial treatment options. According to the American College of Foot and Ankle Surgeons 1, initial treatment options may include open-backed shoes, heel lifts or orthoses, NSAIDs, decreased activity, stretching exercises, and weight loss (if indicated). Some key considerations for treatment include:

• Using open-backed shoes to reduce pressure on the area
• Implementing heel lifts or orthoses to support the foot
• Taking NSAIDs, such as ibuprofen, to reduce pain and inflammation
• Decreasing activity to avoid exacerbating the condition
• Performing stretching exercises to improve flexibility and reduce tension
• Considering weight loss if the patient is overweight, as this can help reduce pressure on the foot If no improvement occurs after six weeks, referral to a podiatric foot and ankle surgeon is appropriate, and additional treatments may include a customized orthotic device, night splinting, or casting 1. It's essential to continue initial treatment measures and consider further options, such as surgery or extracorporeal shock wave therapy, if symptoms persist. Proper footwear with arch support is crucial during recovery to prevent recurrence.

From the FDA Drug Label

In patients with osteoarthritis, the therapeutic action of naproxen has been shown by a reduction in joint pain or tenderness, an increase in range of motion in knee joints, increased mobility as demonstrated by a reduction in walking time, and improvement in capacity to perform activities of daily living impaired by the disease Naproxen has been studied in patients with mild to moderate pain secondary to postoperative, orthopedic, postpartumepisiotomy and uterine contraction pain and dysmenorrhea. Onset of pain relief can begin within 1 hour in patients taking naproxen and within 30 minutes in patients taking naproxen sodium

Treatment for pain from mid foot to heel may be managed with naproxen as it has been shown to be effective in reducing joint pain and improving mobility in patients with osteoarthritis, and has also been studied in patients with mild to moderate pain secondary to orthopedic conditions 2.

• Key benefits: reduction in joint pain, increase in range of motion, and improvement in mobility
• Onset of pain relief: within 1 hour for naproxen, and within 30 minutes for naproxen sodium
• Duration of analgesic effect: up to 12 hours

It is essential to consult a healthcare professional for proper evaluation and treatment of pain from mid foot to heel.

From the Research

Treatment Options for Pain from Mid Foot to Heel

• The treatment for pain from mid foot to heel, often associated with plantar fasciitis, can involve various approaches, including platelet-rich plasma (PRP) injections and corticosteroid injections 3, 4, 5, 6, 7.
• Studies have compared the efficacy of PRP and corticosteroid injections in treating chronic plantar fasciitis, with some indicating that PRP injections may offer better long-term pain alleviation and functional improvement 3, 4, 6, 7.
• However, the effectiveness of these treatments can vary depending on the patient population, with one study suggesting that corticosteroid injections may be more effective in obese patients 5.

Comparison of PRP and Corticosteroid Injections

• A systematic review and meta-analysis found that PRP injections resulted in significantly better American Orthopaedic Foot & Ankle Society scores and lower visual analogue scale scores at 6 and 12 months compared to corticosteroid injections 3.
• Another study reported that PRP injections showed greater improvements in visual analog scale and American Orthopaedic Foot and Ankle Society scores at 1,3, and 6 months compared to corticosteroid injections 4.
• In contrast, a single-blind, randomized clinical trial found that corticosteroid injections were more effective in reducing pain and improving function in obese patients with plantar fasciitis 5.

Efficacy of PRP Injections

• A prospective randomized comparative series found that PRP injections were more effective and durable than cortisone injections for the treatment of chronic recalcitrant cases of plantar fasciitis, with improved American Orthopedic Foot and Ankle Society hindfoot scores at 3,6,12, and 24 months 6.
• A systematic review of randomized controlled trials concluded that PRP injections may lead to a greater improvement in pain and functional outcome over corticosteroid injections in patients with chronic plantar fasciitis 7.