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Solving Foot Ailments

What Are The Causes Of Heel Pain

Overview

Foot Pain

Plantar fasciitis is the most common cause of heel pain, accounting for around four out of five cases. Plantar fasciitis is when the thick band of tissue that connects the heel bone with the rest of the foot (the plantar fascia) becomes damaged and thickened. Damage to the plantar fascia is thought to occur following, sudden damage - for example, damaging your heel while jogging, running or dancing; this type of damage usually affects younger people who are physically active, gradual wear and tear of the tissues that make up the plantar fascia - this usually affects adults who are 40 years of age or over.

Causes

If it hurts under your heel, you may have one or more conditions that inflame the tissues on the bottom of your foot. When you step on a hard object such as a rock or stone, you can bruise the fat pad on the underside of your heel. It may or may not look discolored. The pain goes away gradually with rest. Doing too much running or jumping can inflame the tissue band (fascia) connecting the heel bone to the base of the toes. The pain is centered under your heel and may be mild at first but flares up when you take your first steps after resting overnight. You may need to do special exercises, take medication to reduce swelling and wear a heel pad in your shoe. When plantar fasciitis continues for a long time, a heel spur (calcium deposit) may form where the fascia tissue band connects to your heel bone. Your doctor may take an X-ray to see the bony protrusion. Treatment is usually the same as for plantar fasciitis: rest until the pain subsides, do special stretching exercises and wear heel pad shoe inserts. Having a heel spur may not cause pain and should not be operated on unless symptoms become chronic.

Symptoms

Plantar fasciitis is a condition of irritation to the plantar fascia, the thick ligament on the bottom of your foot. It classically causes pain and stiffness on the bottom of your heel and feels worse in the morning with the first steps out of bed and also in the beginning of an activity after a period of rest. For instance, after driving a car, people feel pain when they first get out, or runners will feel discomfort for the first few minutes of their run. This occurs because the plantar fascia is not well supplied by blood, which makes this condition slow in healing, and a certain amount of activity is needed to get the area to warm up. Plantar fasciitis can occur for various reasons: use of improper, non-supportive shoes; over-training in sports; lack of flexibility; weight gain; prolonged standing; and, interestingly, prolonged bed rest.

Diagnosis

A biomechanical exam by your podiatrist will help reveal these abnormalities and in turn resolve the cause of plantar fasciitis. By addressing this cause, the patient can be offered a podiatric long-term solution to his problem.

Non Surgical Treatment

If you develop heel pain, you can try several methods at home to ease your discomfort. For example rest as much as possible, apply ice to the heel for 10 to 15 minutes twice a day, use over-the-counter pain medications, wear shoes that fit properly, wear night splints, a special device that stretches the foot while you sleep, use heel cups or shoe inserts to reduce pain, If these home care strategies do not ease your pain, you will need to see your doctor. He or she will perform a physical exam and ask you about your symptoms and when they began. Your doctor may also take an X-ray to determine the cause of your heel pain. Once your doctor knows what is causing your pain, he or she will be able to provide you with the appropriate treatment. In many cases, your doctor may prescribe physical therapy. This can help to strengthen the muscles and tendons in your foot, which helps to prevent further injury. If your pain is severe, your doctor may provide you with anti-inflammatory medications. These medications can be injected into the foot or taken by mouth. Your doctor may also recommend that you support your foot as much as possible-either by taping the foot or by using special footwear devices. In very rare cases, your doctor may recommend surgery to correct the problem. However, heel surgery often requires a long recovery time and may not always relieve your foot pain.

Surgical Treatment

Extracorporeal shockwave therapy (EST) is a fairly new type of non-invasive treatment. Non-invasive means it does not involve making cuts into your body. EST involves using a device to deliver high-energy soundwaves into your heel. The soundwaves can sometimes cause pain, so a local anaesthetic may be used to numb your heel. It is claimed that EST works in two ways. It is thought to have a "numbing" effect on the nerves that transmit pain signals to your brain, help stimulate and speed up the healing process. However, these claims have not yet been definitively proven. The National Institute for Health and Care Excellence (NICE) has issued guidance about the use of EST for treating plantar fasciitis. NICE states there are no concerns over the safety of EST, but there are uncertainties about how effective the procedure is for treating heel pain. Some studies have reported that EST is more effective than surgery and other non-surgical treatments, while other studies found the procedure to be no better than a placebo (sham treatment).

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Prevention

Heel Pain

You should always wear footwear that is appropriate for your environment and day-to-day activities. Wearing high heels when you go out in the evening is unlikely to be harmful. However, wearing them all week at work may damage your feet, particularly if your job involves a lot of walking or standing. Ideally, you should wear shoes with laces and a low to moderate heel that supports and cushions your arches and heels. Avoid wearing shoes with no heels. Do not walk barefoot on hard ground, particularly while on holiday. Many cases of heel pain occur when a person protects their feet for 50 weeks of the year and then suddenly walks barefoot while on holiday. Their feet are not accustomed to the extra pressure, which causes heel pain. If you do a physical activity, such as running or another form of exercise that places additional strain on your feet, you should replace your sports shoes regularly. Most experts recommend that sports shoes should be replaced after you have done about 500 miles in them. It is also a good idea to always stretch after exercising, and to make strength and flexibility training a part of your regular exercise routine.