Heel Pain
Heel pain is a common condition in today's society. Most commonly this is caused by a condition called plantar fascitis but other causes of heel pain are routinely seen. These causes would include inferior calcaneal heel spur syndrome, neuritis, stress fracture, tendonitis, bursitis, strain, sprain, arthritis, Reiter syndrome etc.
Because there are several potential causes of heel pain it is important that you see your foot and ankle doctor to address specific problem that you may be having.
Plantar Fasciitis
Plantar fascitis is an inflammation of the band of tissue (the plantar fascia/plantar aponeurosis) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain. This is commonly associated with pain during the first steps in the morning or after rest with improvement with activity.
Because the foot is an arch (greatest medially ) the fascia works to help support this arch against gravity and ground reactive forces . When this band of tissue becomes overworked or excessively strained inflammation occurs causing redness swelling and pain. Because walking is essential to most activity the plantar fascia is not given adequate time to recover from repetitive trauma. In addition most surfaces now days are flat and hard, people are noticing an increased workload, and obesity is prevalent.
As stated before it is important to see your foot and ankle doctor as other symptoms may mimic this presentation. A thorough workup with possibly x-rays or ultrasound may be performed depending on the severity.
Nonsurgical treatment for plantar fascitis would include stretching exercises, icing, elevation, anti-inflammatories, supportive inserts/orthotics, shoegear modification, and limitation of activities.
A strapping of the foot can be performed by your Doctor to see if orthotics would be appropriate for you depending on your condition. If your condition is chronic, other modalities such as orthotics, anesthetic/steroid injections, removable casting , and physical therapy may be appropriate. Over 90% of patients improve with conservative therapy and surgery is not usually needed. The more chronic the condition the more likely surgery is though.
Again it is important that a thorough examination is performed by a doctor familiar with biomechanics so that causes of plantar fascitis will not be overlooked thereby significantly reducing chances of progression/reoccurrence. Below is the plantar fascia at the insertion of the calcaneus with the distal portion cut away (Left). On the right is an x-ray with calcaneal (heel) bone spur indicative of chronic plantar fascitis.
Because there are several potential causes of heel pain it is important that you see your foot and ankle doctor to address specific problem that you may be having.
Plantar Fasciitis
Plantar fascitis is an inflammation of the band of tissue (the plantar fascia/plantar aponeurosis) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain. This is commonly associated with pain during the first steps in the morning or after rest with improvement with activity.
Because the foot is an arch (greatest medially ) the fascia works to help support this arch against gravity and ground reactive forces . When this band of tissue becomes overworked or excessively strained inflammation occurs causing redness swelling and pain. Because walking is essential to most activity the plantar fascia is not given adequate time to recover from repetitive trauma. In addition most surfaces now days are flat and hard, people are noticing an increased workload, and obesity is prevalent.
As stated before it is important to see your foot and ankle doctor as other symptoms may mimic this presentation. A thorough workup with possibly x-rays or ultrasound may be performed depending on the severity.
Nonsurgical treatment for plantar fascitis would include stretching exercises, icing, elevation, anti-inflammatories, supportive inserts/orthotics, shoegear modification, and limitation of activities.
A strapping of the foot can be performed by your Doctor to see if orthotics would be appropriate for you depending on your condition. If your condition is chronic, other modalities such as orthotics, anesthetic/steroid injections, removable casting , and physical therapy may be appropriate. Over 90% of patients improve with conservative therapy and surgery is not usually needed. The more chronic the condition the more likely surgery is though.
Again it is important that a thorough examination is performed by a doctor familiar with biomechanics so that causes of plantar fascitis will not be overlooked thereby significantly reducing chances of progression/reoccurrence. Below is the plantar fascia at the insertion of the calcaneus with the distal portion cut away (Left). On the right is an x-ray with calcaneal (heel) bone spur indicative of chronic plantar fascitis.