Sharp pain in the bottom of the heel with the first steps of the morning is the classic sign of plantar fasciitis. Overnight the plantar fascia tightens; the first steps stretch it suddenly, which causes pain that usually eases after a few minutes of walking.
Why it is worst in the morning
While you sleep, your foot rests pointed slightly downward and the plantar fascia and calf muscles shorten. When you stand, the tissue is stretched abruptly at its attachment on the heel bone, where the damage is concentrated.
The same thing happens after sitting for a while, which is why pain often returns when you stand up after a meal or a drive.
What you can do now
Stretch your calf and the arch of your foot before getting out of bed. Wear supportive shoes or sandals around the house instead of going barefoot on hard floors. Temporarily reduce high-impact exercise.
When it may be something else
Heel pain that is present at night, pain after a fall, numbness or burning, or swelling at the back of the heel point toward other causes, such as a stress fracture, nerve irritation, or an Achilles problem.
When to see a podiatrist
If pain has lasted more than two to three weeks despite these steps, an exam can confirm the diagnosis and start treatment that is more targeted — which often shortens recovery considerably.
From Professional Podiatry Services of New York. General information only; it does not replace an examination.