Are you suffering from Heel Pain?
By Esther Hansen, D.P.M.
Heel pain is not a “normal” condition, although it is a very common one encountered by podiatrists. The majority of sufferers relay a history of “pain the first step in the morning” or “pain after periods of rest.” This particular condition is known as plantar fasciitis. Plantar fasciitis is caused by inflammation of a ligament type structure found on the bottom of the foot; this ligament, called the plantar fascia, runs from the heel bone to the ball of the foot. A common finding associated with plantar fasciitis is a bony growth found on the bottom of the heel called a heel spur. Patients may also complain of arch pain and a tight Achilles tendon. Many factors may aggravate heel pain such as ill fitting shoes, running, jumping or walking on hard unyielding surfaces. The one major cause for heel pain is inflammation of the foot or heel that causes pressure and therefore pain.
Although plantar fasciitis is a common cause of heel pain it is not the only one, other causes of heel pain may include:
- Inflammation (such as bursitis)
- Decrease in the heel’s fat pad (the shock absorbing area found at the bottom of the heel)
- Trauma or injury (which may result in fracture and/or nerve damage)
- Nerve entrapment
- Arthritic changes
- Infections
- Decrease in blood supply to the area
- Improper shoe wear
- Increase in weight
- Tumors
Certain diagnostic test such as X-rays, MRI, CAT scan, nerve studies, vascular studies may be used to rule out some of the above causes of heel pain. In terms of treatments, many people choose to see a physcial therapist. Other people choose to see a podiatrist. Treatments used by podiatrists to combat certain types of heel pain include:
- Instructions on stretching exercises
- Orthotics (custom molded shoe inserts)
- Injections
- Physical therapy
- Instructions on proper shoe wear
- Anti-inflammatories
- Foot strappings
- Shockwave therapy
- Plantar fasciotomy