Heel pain is unlike most body aches and injuries because heels can't be immobilized to rest and recover, at least without considerable inconvenience to the sufferer. Heels can?t be isolated and
splinted either ,as body weight will continue to aggravate the condition with every step. Heel pain can be devastating if left untreated, eventually impairing the ability to walk comfortably-or at
all. Most Heel Pain
comes from tendon problems, though some types can come from bone
issues as well.
Plantar fasciitis can come from a number of underlying causes. Finding the precise reason for the heel pain is sometimes difficult. As you can imagine, when the foot is on the ground a tremendous
amount of force (the full weight of the body) is concentrated on the plantar fascia. This force stretches the plantar fascia as the arch of the foot tries to flatten from the weight of your body.
This is just how the string on a bow is stretched by the force of the bow trying to straighten. This leads to stress on the plantar fascia where it attaches to the heel bone. Small tears of the
fascia can result. These tears are normally repaired by the body. As this process of injury and repair repeats itself over and over again, a bone spur (a pointed outgrowth of the bone) sometimes
forms as the body's response to try to firmly attach the fascia to the heelbone. This appears on an X-ray of the foot as a heel spur. Bone spurs occur along with plantar fasciitis but they are not
the cause of the problem. As we age, the very important fat pad that makes up the fleshy portion of the heel becomes thinner and degenerates (starts to break down). This can lead to inadequate
padding on the heel. With less of a protective pad on the heel, there is a reduced amount of shock absorption. These are additional factors that might lead to plantar fasciitis. Some physicians feel
that the small nerves that travel under the plantar fascia on their way to the forefoot become irritated and may contribute to the pain. But some studies have been able to show that pain from
compression of the nerve is different from plantar fasciitis pain. In many cases, the actual source of the painful heel may not be defined clearly. Other factors that may contribute to the
development of plantar fasciitis include obesity, trauma, weak plantar flexor muscles, excessive foot pronation (flat foot) or other alignment problems in the foot and or ankle, and poor
Both heel pain and heel spurs are frequently associated with an inflammation of the long band of tissue that connects the heel and the ball of the foot. The inflammation of this arch area is called
plantar fasciitis. The inflammation maybe aggravated by shoes that lack appropriate support and by the chronic irritation that sometimes accompanies an athletic lifestyle. Achilles Tendinopathy, Pain
and inflammation of the tendon at the back of the heel that connects the calf muscle to the foot. Sever?s, Often found in children between the ages of 8 - 13 years and is an inflammation of the
calcaneal epiphyseal plate (growth plate) in the back of the heel. Bursitis, An inflamed bursa is a small irritated sack of fluid at the back of the heel. Other types of heel pain include soft tissue
growths, Haglunds deformity (bone enlargement at the back of the heel), bruises or stress fractures and possible nerve entrapment.
A podiatrist (doctor who specializes in the evaluation and treatment of foot diseases) will carry out a physical examination, and ask pertinent questions about the pain. The doctor will also ask the
patient how much walking and standing the patient does, what type of footwear is worn, and details of the his/her medical history. Often this is enough to make a diagnosis. Sometimes further
diagnostic tests are needed, such as blood tests and imaging scans.
Non Surgical Treatment
Calf stretch, silicone Heel cups, ice, night splint, physical therapy. Sometimes custom orthotics are beneficial in long standing cases. Steroid injections have been used and although they
temporarily relieve the pain, the pain usually returns within a short period of time. Plantar fasciitis tends to go away in 90% of all people in time. It can take 12-18 months for all the pain to
resolve. If the pain continues after adequate treatment, high frequency shock wave therapy (OssaTron) has been found to be beneficial, unfortunately most insurance companies do not cover this
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.
A variety of steps can be taken to avoid heel pain and accompanying afflictions. Wear shoes that fit well-front, back, and sides-and have shock-absorbent soles, rigid shanks, and supportive heel
counters. Wear the proper shoes for each activity. Do not wear shoes with excessive wear on heels or soles. Prepare properly before exercising. Warm up and do stretching exercises before and after
running. Pace yourself when you participate in athletic activities. Don't underestimate your body's need for rest and good nutrition. If obese, lose weight.