DEAR DR. DONOHUE: What could be wrong with my heels? I made the mistake of standing too long in one place, and now I can’t get rid of the heel pain. Please help me get to the bottom of this. – H.M.

ANSWER: Let me give you three examples of common heel problems. All of them often respond to rest and heel protection.

Plantar fasciitis is an inflammation of the dense tissue that runs on the bottom of the foot from the front of the heel bone to the toes. It supports the foot arch and provides shock absorption for the foot. The pain from inflamed plantar fascia, a very common disorder, is felt on the sole right in front of the heel bone. It’s at its worst when a person takes the first step of the day, subsides a bit during the day and then worsens toward evening. A test to confirm the diagnosis is to jump and land on the toes. That causes great pain for people with plantar fasciitis.

Cushioning the heel with a heel cup or heel pad protects it and gives it a chance to recuperate. At night, sleep on your back with your toes pointing to the ceiling. You might have to prop them up to keep them in that position. Some doctors favor injecting the heel area with cortisone to calm the inflammation.

A second common condition is fat-pad atrophy. On the bottom of the heel is an accumulation of fat that serves as a natural cushion for the heel. Age thins the fat pad and leaves it unprotected. The pain of fat-pad atrophy is felt in the midportion of the bottom of the heel. The only solution is a heel cup or cushion to act as a substitute.

A third common heel-pain cause is tarsal-tunnel syndrome. At the inner side of the ankle (the side that faces the opposite ankle) is a tunnel through which a nerve passes to reach the foot. Pressure on the nerve as it passes through the tunnel can cause pain from the ankle to the bottom of the foot, or it can cause pain only in the heel area of the bottom of the foot. Cortisone injections and anti-inflammatory medicine like ibuprofen can often relieve pressure on the nerve. Sometimes surgically freeing it is necessary.

DEAR DR. DONOHUE: Our daughter’s son, age 15, is only 5 feet 2 inches tall. We are concerned about his height. He has three brothers, none of whom had any growth problems. The boy is quite self-conscious about his size. The family doctor has nothing to say about this and doesn’t offer any encouragement for a growth spurt. We would appreciate anything you have to say on this matter. – D.M.

ANSWER: Most boys have a growth spurt around age 13.5, and it lasts about one year. During that year they grow, on average, 4 inches (10 cm). Then growth continues, but at a slower rate, up to age 18. Some boys continue to grow even after 18.

Your grandson is at the bottom of the height chart for boys of his age. Since his brothers had no similar growth pattern, it’s not likely that his growth delay is only a family matter that will be overcome in time.

The boy should see a doctor who is knowledgeable in growth physiology. The possibilities for delayed growth are many. Growth-hormone deficiency is one possibility. So are other hormone deficiencies.

Urge your daughter and son-in-law to consult a pediatric endocrinologist soon.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.