Heel Pain & Plantar Fasciitis


plantar fasciitis

Heel pain is one of the most common complaints amongst people who suffer from discomfort in their feet, and no wonder: every mile that we walk places 60 tons of stress on each of our feet, and most of us don’t think twice about it until there is a problem.

One of the biggest issues surrounding foot and heel pain is that most people tend to ignore it and hope that it improves or goes away on its own, but this isn’t usually the case, especially when injury or inflammation is the cause of discomfort. If injury and inflammation in the foot is left untreated the problem may become chronic and require invasive intervention, so it’s best to treat foot problems as soon as they arise.

Heel pain is caused by a multitude of factors but some of the most common culprits include obesity/being overweight, aging, improper footwear, inferior or unorthodox foot mechanics, low levels of physical activity, extremely high levels of physical activity, stress fracture of the heel bone, and working out or standing excessively on hard, unforgiving surfaces.

A very common—and more difficult to treat—reason for heel pain is the development of plantar fasciitis, which occurs when the plantar fascia (the thick band of fibrous tissue that runs from the heel of the foot to the toes via the arch) becomes irritated and inflamed. This condition is usually caused by an abrupt increase in physical activity, training on concrete or other hard surfaces, poor posture, or excessive ankle motion during weight bearing activities. Anything that puts excessive strain on the plantar tendon can cause fasciitis to develop.

Retrocalcaneal Bursitis (Achilles bursitis), may also be to blame. This affliction occurs when the lubricating sack located between the Achilles tendon and the heel bone becomes inflamed, producing swelling and heel pain that usually intensifies when the foot is dorsiflexed.

Heel pain is commonly treated with rest, cold therapy, reduced physical activity and stretching exercises. Sufferers should not go barefoot as this puts more strain on the already inflamed and tender heel. Non-steroidal anti-inflammatory drugs (NSAID’s) such as ibuprofen may used to relieve acute discomfort.

Severe cases of heel pain may also require the use of padding in the shoe to cushion and support overly stressed tendons while strapping helps to reduce strain on the fascia. Orthotic devices also help to evenly distribute pressures in the foot and provide additional arch support, which often decreases heel pain. Removable walking casts may also be used to immobilize the foot, while night splints keep the plantar fascia gently stretched while sleeping. All of these methods may be combined with physical therapy in order to maximize the healing process.

Because of its invasive nature surgery is used as a treatment option in only very severe cases of heel pain, and only if the underlying cause can be remedied by this type of intervention. It is most often used in complicated or extended cases of plantar fasciitis that do not respond to conservative treatment, or if there are other structural issues causing pain that can be corrected in this way. Regardless of why heel pain is occurring long-term care will likely be necessary to prevent the condition from returning.

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