Reviewed by Neoh Jia Cher, Registered TCM Practitioner · November 2026
由注册中医师 梁家榕医师审阅

足底筋膜炎：早上第一步最痛，問題不一定只在腳跟

简单回答：足底筋膜炎最典型的感觉，是早上下床第一步、或坐久站起来时，脚跟内侧刺痛，走一走稍微好一点，站久走久又痛回来。脚跟只是痛的地方；足弓僵住、脚踝和小腿紧绷、膝盖和骨盆的受力歪掉，都会让脚底一直被拉着。醫道閣会从脚往上评估，再用针灸、SRM 结构疗法或推拿处理。

Short answer: the classic sign of plantar fasciitis is a sharp pain on the inner heel with the first steps in the morning, or when you stand up after sitting. It eases a little as you walk, then returns after long standing or walking. The heel is where it hurts, but a stiff arch, a tight ankle and calf, or uneven load through the knee and pelvis can keep pulling on the sole. At Virtue TCM we assess from the feet up, then use acupuncture, SRM structural therapy or tuina.

常見的情況

・早上第一步、久坐站起来时脚跟最痛。
・长时间站立的工作，例如零售、餐饮、护理、教书。
・开始跑步、健走或打球，量一下子增加太多。
・鞋子太硬、太平，或一直穿有固定足弓垫的鞋，脚底自己很少在动。
・体重最近增加，或一边脚曾经扭伤过。

First steps in the morning and standing up after sitting hurt most. It is common in people who stand for work (retail, food, nursing, teaching), who have just increased running, walking or sport too quickly, who wear very hard or flat shoes or rely on a fixed arch support so the foot rarely moves on its own, and in people who have gained weight or once sprained that ankle.

為什麼腳跟一直好不了？

脚底的筋膜，从脚跟一路连到脚趾，再往上和小腿、膝盖、大腿的组织连在一起。足弓本来应该能随着每一步软软地转动、吸收冲击；如果足弓僵住，冲击就全部落在脚跟。脚跟骨、距骨和小腿骨如果没有叠好，整条腿的肌肉也会用歪的角度出力，脚底就一直被扯着。所以只按脚跟、只换鞋垫，常常只能撑一阵子。

The fascia under the foot runs from the heel to the toes and connects up through the calf, knee and thigh. The arch is meant to give a little with every step and absorb impact; when it is stiff, the heel takes the load. When the heel bone, ankle bone and shin bone are not stacked well, the whole leg works at a slight angle and the sole stays under tension. That is why only massaging the heel or only changing insoles often helps for a while and then wears off.

SRM 怎麼看足底筋膜炎

先让脚叠正。医师会看你站着、蹲下、走路时，脚跟、脚踝和小腿有没有叠在同一条线上。
一根一根脚趾、再到足弓。小趾那一侧松开，小腿外侧才会松；大拇趾那一侧松开，脚踝内侧和膝盖内侧的肌肉才会开始放松。脚趾和足弓都可以动了，脚底的筋膜才有空间。
再往上看。小腿、膝盖、骨盆如果一直扭着，脚底还是会被拉，所以需要时会一起处理。
做完一定检查。踩地、垫脚尖、蹲下，脚跟的刺痛和足弓的卡感应该比较少；还没松开的地方，医师会说明。

Stack the leg first. We look at whether the heel, ankle and shin line up when you stand, squat and walk. Toe by toe, then the arch. Freeing the little-toe side lets the outer calf relax; freeing the big-toe side lets the inner ankle and inner knee muscles let go. Once the toes and arch can move, the fascia under the foot has room. Then look higher. A twisted calf, knee or pelvis keeps pulling on the sole, so these are treated when needed. Check before you leave. Stepping, rising onto your toes and squatting should feel easier; anything still stuck will be explained.

在家可以先注意的事

・早上下床前，先在床上转转脚踝、动动脚趾，再慢慢站起来。
・痛的时候先减少跑步和长时间站立，不要忍着痛加量。
・鞋子选有一点缓冲、但脚掌可以自然弯曲的，不要整天穿太硬的鞋。
・在家可以偶尔赤脚慢慢走，让脚趾和足弓自己动，前提是不会更痛。
・痛超过几个礼拜没有改善，或越来越严重，就该让医师看看。

Before getting out of bed, circle your ankles and move your toes, then stand slowly. Cut back on running and long standing while it hurts. Choose shoes with some cushioning that still let the forefoot bend, rather than very rigid shoes all day. At home, walking slowly barefoot now and then lets the toes and arch move, as long as it does not make the pain worse. If it has not improved after a few weeks, or is getting worse, have it assessed.

第一次來會做什麼？

问诊约 15 分钟：痛了多久、什么时候最痛、工作要站多久、穿什么鞋、有没有扭伤过，也会把脉看舌。接着看你站、蹲、走的样子，再决定当天用针灸、SRM 或两者搭配。初诊问诊 RM60（带 X 光或报告 RM100），复诊 RM30；疗程费用另计，开始前会先说明。

A consultation of about 15 minutes covers how long it has hurt, when it is worst, how long you stand at work, your shoes and any old sprains, plus pulse and tongue. Then we watch you stand, squat and walk and decide on acupuncture, SRM or both. First consultation RM60 (RM100 if we review X-rays or reports), follow-up RM30; treatment is priced separately and explained before anything starts.

這些情況請先看西醫

受伤后脚跟或脚掌肿得很快、不能踩地；脚底麻木、刺麻或发冷；红肿发热或发烧；糖尿病患者脚上有伤口或颜色改变；或痛到晚上休息时也痛，请先到医院检查。

If the heel or foot swells quickly after an injury or you cannot put weight on it, the sole is numb, tingling or cold, it is hot and red or you have a fever, you have diabetes and notice a wound or colour change on the foot, or it hurts even at rest at night, please see a doctor first.

延伸閱讀

膝盖痛不一定是膝盖的问题

腰背痛调理 Back Pain Treatment

SRM 系统还原手法‧结构疗法

针灸 Acupuncture

个人情况因人而异，疗程建议需经问诊与医师评估后决定。
Individual conditions vary. Recommendations follow consultation and practitioner assessment.

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