From the Guidelines
I strongly recommend that you see a healthcare provider for proper diagnosis and treatment of your heel pain, which has persisted for a month and may be related to your high arches and inadequate support. In the meantime, try dedicated heel cups rather than full insoles, as they provide targeted cushioning for bruised heels, as suggested by the American College of Foot and Ankle Surgeons 1. Look for silicone heel cups that absorb shock better than gel. Since you have high arches, custom orthotics are indeed beneficial, but ensure they're specifically designed for heel pain. Rest your foot when possible, apply ice for 15-20 minutes several times daily, and take over-the-counter anti-inflammatories like ibuprofen (400-600mg every 6-8 hours with food) to reduce pain and inflammation, as recommended by initial treatment options 1. Gentle stretching exercises for your calf muscles and plantar fascia can help - try pulling your toes toward your shin for 30 seconds, repeating 3 times, several times daily. Some key points to consider:
- Heel pain that persists for a month warrants medical attention, as proper diagnosis ensures appropriate treatment, and if no improvement occurs after six weeks, referral to a podiatric foot and ankle surgeon is appropriate 1.
- High arches place additional stress on heels, making proper support crucial for healing and preventing recurrence.
- Initial treatment measures, including orthoses, NSAIDs, decreased activity, stretching exercises, and weight loss (if indicated), should be continued until symptoms resolve, as suggested by 1.
From the Research
Heel Pain and Orthotics
- The use of foot orthoses for treating plantar heel pain has been studied, and the results show that they are not superior to sham or other conservative treatments in improving pain and function 2.
- Custom orthoses, like the ones you had made for your high arch, may not be more effective than prefabricated orthoses for short-term pain relief 2.
- However, foot orthoses can improve postural stability and balance control in older adults, which may be beneficial for overall foot health 3.
Treatment Options
- Since your heel pain is not due to a bone spur, but rather bruising, you may want to consider using gel heel cups or better-quality insoles to reduce pressure and discomfort.
- The study on foot orthoses and shoe characteristics suggests that wearing thin, hard-soled footwear with high collars can reduce the risk of falling, but it's unclear if this would directly impact heel pain 3.
- There is limited research on the specific use of foot orthoses for heel bruising, and more studies are needed to determine their effectiveness for this condition.
Reassurance and Supportive Therapy
- Reassurance therapy, which involves questioning and examining the patient, assuring them that serious illness is not present, and suggesting that symptoms will resolve, can be an effective treatment approach for patients with benign or non-existent medical disease 4.
- Supportive therapy, which involves collaborative work between the patient and provider to reduce distress and enhance functioning, can also be beneficial for patients struggling with medical illnesses, including those with musculoskeletal conditions 5.