The plantar fascia is a thick, ligamentous connective tissue that runs from the heel bone to the ball of the foot. This strong and tight tissue helps maintain the arch of the foot. It is also one of
the major transmitters of weight across the foot as you walk or run. Thus, tremendous stress is placed on the plantar fascia, often leading to plantar fasciitis- a stabbing or burning pain in the
heel or arch of the foot. Plantar fasciitis is particularly common in runners. People who are overweight, women who are pregnant and those who wear shoes with inadequate support are also at a higher
risk. Prolonged plantar fasciitis frequently leads to heel spurs, a hook of bone that can form on the heel bone. The heel spur itself is not thought to be the primary cause of Heel Pain
, rather inflammation and irritation of the plantar fascia is thought to be the primary
some heel pain can be caused by rheumatological diseases, and these pains can do a real good impersonation of plantar fasciitis symptoms. Seronegative Arthropathies such as Psoriatic Arthritis,
Reactive Arthritis and Ankylosing Spondylisis are the most common types to cause heel pain by producing an inflammatory reaction where the fascia attaches to the heel. This is called an enthesitis.
If you have a history of Psoriasis or a family history of other arthritic conditions listed above we recommend you see a clinician about your heel pain to confirm the diagnosis. Another occasional
cause of heel pain is loss of the cushioning fat pad of the heel, which can result in a bruised heel bone (calcaneus). If you can easily feel your heel bone through your skin on the bottom of your
foot you may well have poor fatty tissue on your heel. Pressing on the centre of your heel should feel like pushing into firm rubber, and your skin should not move easily. If you can pinch the skin
under your heel and feel a very hard lump when you press the bottom of your heel then it is likely you have a heel fat pad problem. One simple final test is to walk on a hard floor. If you feel the
pain only when your heel hits the ground a fat pad problem is most likely. If the pain mainly occurs as you lift the heel off the ground it is more likely to be plantar fasciitis.
The symptoms of plantar fasciitis are pain on the bottom of the heel, pain in the arch of the foot, pain that is usually worse upon arising, pain that increases over a period of months. People with
plantar fasciitis often describe the pain as worse when they get up in the morning or after they?ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because
walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.
Your doctor will perform a physical exam and ask questions about your medical history and symptoms, such as have you had this type of heel pain before? When did your pain begin? Do you have pain upon
your first steps in the morning or after your first steps after rest? Is the pain dull and aching or sharp and stabbing? Is it worse after exercise? Is it worse when standing? Did you fall or twist
your ankle recently? Are you a runner? If so, how far and how often do you run? Do you walk or stand for long periods of time? What kind of shoes do you wear? Do you have any other symptoms? Your
doctor may order a foot x-ray. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot. Your doctor may recommend a night splint to help stretch your foot.
Surgery may be recommended in some cases.
Non Surgical Treatment
Heel pain often goes away on its own with home care. For heel pain that isn't severe, try the following. Rest. If possible, avoid activities that put stress on your heels, such as running, standing
for long periods or walking on hard surfaces. Ice. Place an ice pack or bag of frozen peas on your heel for 15 to 20 minutes three times a day. New shoes. Be sure your shoes fit properly and provide
plenty of support. If you're an athlete, choose shoes appropriate for your sport and replace them regularly. Foot supports. Heel cups or wedges that you buy in the drugstore often provide relief.
Custom-made orthotics usually aren't needed for heel problems. Over-the-counter pain medications. Aspirin or ibuprofen (Advil, Motrin IB, others) can reduce inflammation and pain.
Surgery to correct heel pain is generally only recommended if orthotic treatment has failed. There are some exceptions to this course of treatment and it is up to you and your doctor to determine the
most appropriate course of treatment. Following surgical treatment to correct heel pain the patient will generally have to continue the use of orthotics. The surgery does not correct the cause of the
heel pain. The surgery will eliminate the pain but the process that caused the pain will continue without the use of orthotics. If orthotics have been prescribed prior to surgery they generally do
not have to be remade.
Prevention of heel pain involves reducing the stress on that part of the body. Tips include. Barefeet, when on hard ground make sure you are wearing shoes. Bodyweight, if you are overweight there is
more stress on the heels when you walk or run. Try to lose weight. Footwear, footwear that has material which can absorb some of the stress placed on the heel may help protect it. Examples include
heel pads. Make sure your shoes fit properly and do not have worn down heels or soles. If you notice a link between a particular pair of shoes and heel pain, stop wearing them. Rest, if you are
especially susceptible to heel pain, try to spend more time resting and less time on your feet. It is best to discuss this point with a specialized health care professional. Sports, warm up properly
before engaging in activities that may place lots of stress on the heels. Make sure you have proper sports shoes for your task.