Doc, my heel is killing me. What can I do?

Dr Flo,
I have been having a problem with my left heel for some time now. It began like a sharp pain whenever I was standing and gradually moved to difficulty when making first steps. Currently, it worsens whenever I walk for some time. I can actually gauge my heart beat by touching my heel based on the pumping extent. I feel like I’m developing a limp because of the pain in my heel. I can no longer run. Worse still, I hardly manage a firm erection. My sex drive is going down and I’m 30 years old. S A

Dear S A,
You are most likely suffering from plantar fasciitis, which means inflammation of the fascia on the bottom of your foot. The plantar fascia is like a sheet of fibrous tissue that connects the heel to the front of the foot, where the toes start. It supports the foot, and helps us walk by acting as a shock absorber. It can easily get injured or torn due to too much pressure on the feet.
When this happens, there is pain, usually after starting to walk after sitting or lying down for long, or after being on your feet for long. It is more common in those who are overweight or obese, those whose jobs require them to stand or walk for long durations of time, and also long distance runners. It can also occur during late pregnancy, and also in those with flat feet or a high foot arch. Wearing shoes with poor arch support also contributes to the problem.
To manage it, reduce the pressure on your feet by reducing the walking and standing. You can stretch and massage your feet before getting out of bed in the morning and after being on your feet for long. Get heel cushions or wear shoes with good arch support and a cushioning sole. Pain killers help to reduce the pain and inflammation. You can also see a physiotherapist to help with the exercises for the feet and legs. In case you have tried all this and you are still in a lot of pain, you may require a steroid injection to the damaged area, which should be done by an orthopaedic specialist. Other treatments that the orthopaedist may recommend include using splints, plantar iontophoresis (using an electric current to get an applied drug to get into the foot), extracorporeal shock wave therapy and surgery.

Dr Flo,
For some time now, my urine has had a strong smell like ammonia and forms foam when I pee. Also, I frequently experience pain in my testicles (sort of on one side). The pain I feel is like when balls are squeezed hard. What is the remedy for that? B O

Dear B O,
The foul smelling urine and testicular pain most likely means that you have an ongoing infection. It may be due to gonorrhoea, chlamydia, trichomonas, or infection by other organisms. Most likely, you acquired the infection through sexual transmission from any partner you have had in the past three to six months.
You need to have a sample of the urine taken for analysis and culture in a good laboratory. You also need an STI screen including chlamydia and HIV tests. You would also benefit from a testicular ultrasound. You will be given antibiotics to treat the infection, depending on the results. Abstain from sexual intercourse until you have completed treatment, and you have been retested and found to be cured. Any partners you have had in the past three to six months also need to be treated for their own health’s sake, and also to prevent reinfecting you.

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