Plantar Fasciitis (Heel Pain)
Heel pain can be a complex, ongoing process. This disorder can be very frustrating, and can interfere with daily activities such as work or recreation.
The condition can usually be successfully treated with conservative measures such as use of anti-inflammatory medications, biomechanical modification (orthotics), strapping, and stretching exercises.
Treatment programs vary with each individual situation and response.
Heel Pain Has Many Causes
In our pursuit of healthy bodies, pain can be an enemy. In some instances, however, it is of biological benefit. Pain that occurs right after an injury or early in an illness may play a protective role, often warning us about the damage we’ve suffered.
Pain in our heels is no different. It is important to seek medical attention for this problem due to the many conditions which may cause heel pain. It is not natural for us to experience pain in our feet, so with the help of your physician you can eliminate the pain in your feet entirely.
Heel Pain/Plantar Fasciitis
Heel pain is generally the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. The injury occurs over time as the plantar fascia is strained and pulled beyond its normal limits, causing repetitive microtrauma, inflammation, and even bony spurs to occur within the tissue. The reason shoe inserts (orthotics) are so successful in the treatment of heel pain is because they help to control the abnormal stresses placed on these tissues. The stress may also result from injury or a bruise incurred while walking, running, or jumping on hard surfaces. Recent weight gain or the use of poorly constructed or worn out shoes can also aggravate this condition. The pain is typically at its worst after periods of rest, such as the first step out of bed in the morning or after long periods of sitting and improves as the day goes on.
The heel bone is the largest of the 26 bones in the human foot, which also has 33 joints and a network of more than 100 tendons, muscles, and ligaments. Like all bones, it is subject to outside influences that can affect its integrity and its ability to keep us on our feet. Heel pain, sometimes disabling, usually occurs on the bottom of the heel and this is called plantar fasciitis. Pain on the back of the heel or on the sides of the heel are indicative of other problems. Fortunately, approximately 90% of people with plantar fasciitis improve without the need for surgery. Unlike some other condtions, following your doctor’s orders and treatment plan for plantar fasciitis can greatly improve your quality of life in a relatively short period of time.
Patients with plantar fasciitis will often demonstrate heel spurs on x-rays, but these spurs are not typically the root of the problem. They are, however, the result of the problem which is excessive strain and pull on the plantar fascia. at its attachment on the heel. Doctors agree that the appearance of heel spurs on an x-ray does not by itself mean that a person needs surgery. Some people have heel spurs and no pain; others have heel pain and no spurs.
Other Causes of Heel Pain
Some general health conditions can also bring about heel pain. Rheumatoid arthritis and other forms of arthritis, including gout, can cause heel discomfort in some cases.
Heel pain may also be the result of an inflamed bursa (bursitis), a small, irritated sack of fluid; a neuroma (a nerve growth); or other soft-tissue growth. Such heel pain may be associated with a heel spur or may mimic the pain of a heel spur.
Haglund’s deformity (“pump bump”) is a bone enlargement at the back of the heel bone, in the area where the achilles tendon attaches to the bone. This sometimes painful deformity generally is the result of bursitis caused by pressure against the shoe and can be aggravated by the height or stitching of a heel counter of a particular shoe.
Pain at the back of the heel is associated with inflammation of the achilles tendon as it runs behind the ankle and inserts on the back surface of the heel bone. The inflammation is called achilles tendinitis. It is common among people who run and walk a lot and have tight tendons. The condition occurs when the tendon is strained over time, causing the fibers to tear or stretch along its length, or at its insertion on to the heel bone. This leads to inflammation, pain, and the possible growth of a bone spur on the back of the heel bone. The inflammation is aggravated by the chronic irritation that sometimes accompanies an active lifestyle and certain activities that strain an already tight tendon.
Bone bruises are common heel injuries. A bone bruise or contusion is an inflammation of the tissues that cover the heel bone. A bone bruise is a sharply painful injury caused by the direct impact of a hard object or surface on the foot. Stress fractures of the heel bone also can occur, although infrequently.
Heel pain can also occur in children, most commonly between ages 8 and 13, as they become increasingly active in sports activity in and out of school. This physical activity, particularly jumping, inflames the growth centers of the heels; the more active the child, the more likely the condition will occur. When the bones mature, the problems disappear and are not likely to recur. If heel pain occurs in this age group, podiatric care is necessary to protect the growing bone and to provide pain relief. Other good news is that heel spurs do not often develop in children.
Heel Pain Tips
If you have experienced painful heels try wearing your shoes around your house in the evening. Don’t wear slippers or socks or go barefoot. You may also try gentle calf stretches for 20 to 30 seconds on each leg. This is best done barefoot, leaning forward towards a wall with one foot forward and one foot back.
If the pain persists longer than one week, you should visit a podiatrist for evaluation and treatment. Your feet should not hurt, and professional podiatric care may be required to help relieve your discomfort.
If you have not exercised in a long time, consult your podiatric physician before starting a new exercise program.
You can follow these easy tips:
- Begin an exercise program slowly. Don’t go too far or too fast.
- Purchase and maintain good shoes and replace them regularly.
- Stretch each foot and achilles tendon before and after exercise.
- Avoid uneven walking surfaces or stepping on rocks as much as possible.
- Avoid going barefoot on hard surfaces.
- Vary the incline on a treadmill during exercise.
- If it hurts – stop immediately and see your doctor right away.