If your sole is severely painful when you take your first step in the morning, what should you check?

When you take your first step after waking up and feel a sharp pain in the sole or heel of your foot, which then improves somewhat after walking a few steps, this may indicate that the plantar fascia or surrounding tissues around the heel are being repeatedly stimulated.

Check whether you have recently increased your standing time or walking activity, changed your shoes, or experienced weight changes; doing so can help identify the cause.

• Severe sole and heel pain upon the first steps in the morning
• Pain eases after walking for a while but worsens again after a long walk
• Pain worsens after prolonged standing or activity.
• Pain is reproduced when pressing on the heel.
• It worsens when walking on a hard surface barefoot.
• Recently, exercise volume or body weight has increased.

It is necessary to check whether the pain is on one side or both sides, and whether there is also numbness in the top of the foot or the toes.

If there is sudden severe pain without trauma, accompanied by swelling and warmth in the foot, you must check for infection or other inflammatory conditions. If the feet become pale or cold and sensation drops rapidly, immediate consultation is required.

In cases of diabetes, foot sole wounds and sensory loss must be examined with particular care.

We examine the nature of pain, onset timing, activity level and footwear, and changes in body weight. We examine the movement of the ankle and toes, the location of plantar tenderness, and weight-bearing gait.

In cases of recurring pain, we also check whether calf muscle strength and ankle mobility, as well as the alignment of the knees and hips, affect gait.

When there are no warning signs and movement restriction in the ankle/foot joints and tension in the calf muscles appear related to pain, Chuna manual therapy and acupuncture combined with pharmacopuncture can be considered.

Rather than suddenly increasing or greatly reducing activity, it may help to gradually adjust walking time, footwear and activity on hard floors, while also stretching the calves and soles of the feet.