Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in pain within the heel, arch or sole of the foot.
The symptoms of plantar fasciitis can include:
• Pain on the bottom of the heel, along the arch and/or the bottom of the foot
• Pain that is usually worse upon weight bearing after periods of rest (in the morning or after siting for extended periods of time)
• Pain that increases over a period of months
The most common cause of plantar fasciitis results to faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fasciitis. Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when one’s job requires long hours on the feet. Carrying excessive weight may also contribute to plantar fasciitis.
To arrive at a diagnosis podiatrist will review diagnostic imaging studied such as x-ray and/or other imaging modalities such as ultrasound to look for bone deformities and swelling within the tissues. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain.
• Stretching exercises that stretch out the calf muscle
• Wear supportive shoes only and avoid going barefoot
• Ice heel for 20 minutes 2-3 times a day
• Limit activities that cause strain or trauma to feet (i.e. running, jumping, extended standing on hard surfaces)
• Oral non-steroidal anti-inflammatory drugs such as ibuprofen to reduce pain and inflammation
• Night Splint to stretch your plantar fascia and calf muscle
• Braces and/or custom orthotics to support your plantar fascia
• Injection of a corticosteroid into the inflamed tissue to reduce inflammation and relieve pain
• Removable walking cast that immobilizes foot to allow it to rest for a few weeks
• Physical therapy to provide exercises and stretches to help reduce the pain and inflammation
• Surgery to release the plantar fascia and reduce a bone spur is performed only if non-surgical treatments are unsuccessful