Heel Pain (E.g. Plantarfasciitis
)
Plantar Fasciitis, often referred to as a "heel spur" is a common foot problem. It starts as a dull intermittent pain in the heel which may progress to a sharp persistent pain. Usually worse in the morning with the first few steps, or after sitting for a period of time and then standing up. The pain normally goes away when you start walking but recurs after a period of rest. If left untreated Plantar Fasciitis develops to severe pain that can stop you from weight bearing on your heel. The plantar fascia is a broad band of fibrous tissue which runs along the bottom surface of the foot. It is attached to the heel bone (calcaneous) and fans forward toward the toes.
Plantar Fasciitis is caused by inflammation of the tissues connected to the heel bone, due to excessive pulling and stretching of the fibrous bands that support the arch of the foot. Continuation of this irritation can lead to heel pain, arch pain or a bony growth on the bottom of the heel bone called a "heel spur".
Heel Pain Syndrome
Not all heel pain is plantarfasciitis, heel pain syndrome is caused by repetitive pressure placed on the heel of the foot when walking, which causes soreness of the heel. "Itis" usually refers to the inflammation of a certain part of the body, therefore Bursitis refers to the constant irritation of the natural cushion that supports the heel of the foot (the bursa). Bursitis is often associated with Plantar Fasciitis, which affects the arch and heel of the foot.
Causes of Heel Pain
Bursitis and Plantar Fasciitis can occur when a person increases their levels of physical activity or when the heel's fat pad becomes thinner, providing less protection to the foot.
Other causes can include:
- Ill fitting shoes
- Obesity
- Biomechanical problems (e.g. mal-alignment of the foot, including over-pronation)
- Gout
- Rheumatoid arthritis
Prevention & treatment of heel pain:
Orthotics (special insoles) is the best treatment for this type of condition as they address the underlying biomechanical cause, and take strain off the injuried structure so that it can heal. Orthotics are not Arch supports. Orthotics address biomechanical function of the foot, while arch supports simply “pack” the arch. Arch supports may offer short term pain relieve for heel pain but will lead to weakening of the foot structures in the long term.
Appropriate footwear is a key consideration in preventing heel pain; Foot Mechanics Podiatrists are experts in shoe recommendation.
Other common components of a treatment plan for Plantar Fasciitis and Bursitis include:
- Cold presses or ice packs
- Anti-inflammatory tablets
- Cushioning
- Massaging the foot
- Muscle strengthening
- Stretching exercises
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