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At last, summer is here. After months wearing boots and thick-soled shoes, many are welcoming the warmer weather sporting flip-flop sandals, however, their popularity among teens and young adults is responsible for a growing epidemic of heel pain in this population.

Podiatrists are seeing more heel pain than ever in patients 15 to 25 years old, a group that usually doesn’t have this problem. A major contributor is wearing flip-flop sandals with paper-thin soles everyday to school. Flip-flops have no arch support and can accentuate any abnormal biomechanics in foot motion, and this eventually brings pain and inflammation.

With warm weather on the horizon for most of the country, we advise wearing sandals with reasonably strong soles and arch support. Especially for girls and young women, thicker soled sandals with supportive arches might not be considered stylish, but if you want to wear sandals most of the time, you’ll avoid heel pain if you choose sturdier, perhaps less fashionable styles.

Heel pain also is becoming more prevalent in younger people who become overweight and lead sedentary lifestyles in winter and dramatically increase their physical activity when the temperatures rise. Obesity in younger people has become a major health problem and heel pain is a consequence of it.

It is estimated that 15 percent of all adult foot complaints involve plantar fasciitis, the type of heel pain caused by chronic inflammation of the connective tissue extending from the heel bone to the toes. Being overweight and wearing inappropriate footwear are common contributing factors. The pain is most noticeable after getting out of bed in the morning, and it tends to decrease after a few minutes and returns during the day as time on the feet increases.

Not all heel pain, however, is caused by plantar fasciitis. It also can occur from inflammation of the Achilles tendon, bursitis, arthritis, gout, stress fractures, or irritation of one or more of the nerves in the region. Sometimes in such cases, heel pain could be a symptom of a serious medical condition that should be diagnosed and treated separately.

Clinical guidelines published by the American College of Foot and Ankle Surgeons are helping physicians diagnose and manage all types of heel pain and distinguish cases that should be treated conservatively from those that require more specialized care. The guidelines state that initial treatment options for heel pain caused by plantar fasciitis should include anti-inflammatory medications, padding and strapping of the foot and physical therapy. Patients also should stretch their calf muscles regularly, avoid wearing flat shoes and walking barefoot, use over-the-counter arch supports and heel cushions, and limit the frequency of extended physical activities.

Most patients with plantar fasciitis respond to conservative treatment within six weeks. However, surgery is sometimes necessary to relieve severe, persistent pain.

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