### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have had severe foot pain for over a year .it is mostly in the heel it has now started in the other foot. I have tried massage .cortisone shot ,ice,heat, over the counter pain relievers, ultrasound therapy , inserts and xray sometimes I can barely walk and prolonged standing and walking are most days unbearable. Im a 44 year old female with no major medical problems no recent injurys to feet  and awful insurance any suggestions to a diagnosis or relief?

### output:

Hello, I have studied your case. As per your history I would like to give differential. There is possibility of early plantar fasciitis, or can early arthritis. For plantar fasciitis, Shoe/footwear should be with soft sole. You can use silicon pad insoles. Avoid exposure of cold to foot. Start plantar exercises consulting physiotherapist also Physiotherapy like TENS and ultrasound will help. Take calcium supplement with it D. Do exercises of foot before getting out of bed. As per your history another possibility of inflammatory arthritis. You may need to do blood test to confirm diagnosis. When such patients come to our hospital I advise them blood test like RA factor, CCP, ESR, complete blood count, HLA B27, thyroid profile. For these symptoms' medication like methylcobalamine and analgesic will reduce pain; you can take them consulting your treating doctor. If not relieved then you may need arthroscopic release of fascia. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care.