Heel Pain (Plantar Fasciitis)

Description

Sharp pain, aching or stiffness on the bottom of one or both heels (or arches) is a very common ailment. The pain is often at its worst upon first walking in the morning (or standing up after sitting), causing either hobbling or limping for a few minutes before a comfortable stride can be resumed. As weight continues to be applied during walking or standing, mild or severe pain may persist

Causes

Heel pain originates deep within the foot, directly on the heel bone or most commonly within the foot’s fibrous band of connective tissues, called the plantar fascia. Several layers of fatty tissue surround the heel bone, softening the impact of walking and running and protecting the bones and muscles of the foot. Beneath this padding, the plantar fascia extends from the heel bone, supporting the arch and reaching across to the toes. As we age, gain weight or place excessive strain on our feet, the feet roll inwards causing the arches to lower and the foot to lengthen. This motion, called pronation, causes the plantar fascia to strain or tear from its insertion into the heel bone and results in the heel pain. Pain can also result when these tissues become irritated or inflamed.

Other Possible Causes

While injury, overuse or other temporary, mechanical causes can bring on discomfort in the heel, a painful heel may also indicate more serious conditions such as:

  • Gout
  • Nerve Injuries
  • Arthritis
  • Heel Bone Abnormalities
  • Collagen Disorders
  • Tumors
  • Psoriasis

Treatments

In most cases, heel pain can be relieved without surgery by using one of more of the following treatments:

Strapping

Since the most common cause of plantar fasciitis is improper foot mechanics, control of the heel pain is often properly managed by controlling the motion of the foot. Strapping the foot with tape can reduce the pull on tissues and help support bones and joints. Strapping may temporarily improve foot function, thereby reducing pain and swelling. This can help determine whether custom orthotics are indicated for your condition as orthotics control foot motion in a similar way to strapping.

Orthotics

Custom orthotics are made from plaster impressions taken of your feet while they are held in the optimal position. Over a period of time, wearing custom orthotics may allow the plantar fascia to heal, thereby eliminating the need for orthotics other than for heavy walking or prolonged standing.

Injection

To control extreme or chronic inflammation, an injection of anti-inflammatory medication may be necessary. This can help to reduce pain and inflammation but is not a permanent solution, as it does not treat the cause of the pain.

Stretching

A tight achilles tendon and hamstring muscles in the leg and thigh can intensify the symptoms of plantar fascitis. Routine stretching exercises or physiotherapy can help heel pain if you have tight muscles or a limited range of motion in the joint.

Surgery

If the above treatments are unsuccessful in reducing the inflammation and eliminating the pain, surgery may be required to release the tight ligaments. This surgery is usually done on an outpatient basis under a local anesthetic.

Heel pain is a very common problem and can usually be treated quickly and easily. If you have any further questions or concerns, please ask the doctor during your appointment.