Heel pain can be caused by many things including a stress fracture, arthritis, tendinitis, nerve irritation or a condition known as plantar fasciitis which is the most common cause of heel pain. Plantar fasciitis is caused by inflammation of the band of tissue, known as the plantar fascia, becomes irritated and inflamed resulting in pain. This fascia extends from the heel to the toes.
Symptoms include:
- Pain on the bottom of the heel
- Pain that is usually worse upon arising in the morning or after a period of rest
- Pain that increases over a period of months
The pain that people experience usually decreases initially with walking because the fascia is being stretched, but after continued use the pain tends to get worse due to irritation.
Causes:
- Excessively flat or high-arched feet can be prone to plantar fasciitis.
- Not wearing supportive footwear on hard flat surfaces puts abnormal strain on the fascia.
- Obesity can contribute to plantar fasciitis
A diagnosis involves a thorough examination of the foot as well as your medical history. Diagnostic imaging studies such as x-rays, MRIs or a Bone Scan may be performed to differentiate between the types of heel pain.
Conservative Treatment can include:
- Stretching exercises
- Rest and Ice
- Shoe modifications/always wearing supportive shoes
- NSAIDs to reduce inflammation
- Weight loss to reduce excess stress on the fascia
When you see your doctor, (s)he may try one or more of the following approaches:
- Shoe padding and strapping the foot
- Orthotic devices
- Corticosteroid injection
- A removable walking cast
- A night splint
- Physical therapy
- Few patients may require surgery if no improvement is seen
Long-Term Prevention/Care:
No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventative measures. If you are overweight, it is important to reach and maintain an ideal weight. For all patients, wearing supportive shoes and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.
