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.
Heel pain is often the result of the plantar fascia being overstretched or overused. Risk factors include. Obesity or sudden weight gain. Long distance running. Tight Achilles tendons. Shoes with
poor arch support or soft soles. Foot arch problems (both high arches and flat feet).
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.
The diagnosis of plantar fasciitis is generally made during the history and physical examination. There are several conditions that can cause heel pain, and plantar fasciitis must be distinguished
from these conditions. Pain can be referred to the heel and foot from other areas of the body such as the low back, hip, knee, and/or ankle. Special tests to challenge these areas are performed to
help confirm the problem is truly coming from the plantar fascia. An X-ray may be ordered to rule out a stress fracture of the heel bone and to see if a bone spur is present that is large enough to
cause problems. Other helpful imaging studies include bone scans, MRI, and ultrasound. Ultrasonographic exam may be favored as it is quick, less expensive, and does not expose you to radiation.
Laboratory investigation may be necessary in some cases to rule out a systemic illness causing the heel pain, such as rheumatoid arthritis, Reiter's syndrome, or ankylosing spondylitis. These are
diseases that affect the entire body but may show up at first as pain in the heel.
Non Surgical Treatment
If you have experienced painful heels try wearing your shoes around your house in the evening. Don't wear slippers or socks or go barefoot. You may also try gentle calf stretches for 20 to 30 seconds
on each leg. This is best done barefoot, leaning forward towards a wall with one foot forward and one foot back. If the pain persists longer than one month, you should visit a podiatrist for
evaluation and treatment. Your feet should not hurt, and professional podiatric care may be required to help relieve your discomfort. If you have not exercised in a long time, consult your podiatric
physician before starting a new exercise program. Begin an exercise program slowly. Don't go too far or too fast. Purchase and maintain good shoes and replace them regularly. Stretch each foot and
achilles tendon before and after exercise. Avoid uneven walking surfaces or stepping on rocks as much as possible. Avoid going barefoot on hard surfaces. Vary the incline on a treadmill during
exercise. Nobody walks uphill all the time. If it hurts, stop. Don't try to "work through the pain." Your podiatric physician/surgeon has been trained specifically and extensively in the diagnosis
and treatment of all manner of foot conditions. This training encompasses all of the intricately related systems and structures of the foot and lower leg including neurological, circulatory, skin,
and the musculoskeletal system, which includes bones, joints, ligaments, tendons, muscles, and nerves.
Although most patients with plantar fasciitis respond to non-surgical treatment, a small percentage of patients may require surgery. If, after several months of non-surgical treatment, you continue
to have heel pain, surgery will be considered. Your foot and ankle surgeon will discuss the surgical options with you and determine which approach would be most beneficial for you. No matter what
kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. Wearing supportive
shoes, stretching, and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.
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.