Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress
fracture, tendonitis, arthritis, nerve irritation, or, rarely, a cyst. Because there are several potential causes, it is important to have heel pain properly diagnosed. A foot and ankle surgeon is
able to distinguish between all the possibilities and determine the underlying source of your heel pain. Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends
from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain.
Heel pain has a number of causes that are typically associated with overuse of the heel bone. You can strain your heel by pounding your feet on hard surfaces, being overweight, or wearing shoes that
do not fit properly. These strains can irritate the heel?s bones, muscles, or tendons. Other common causes of heel pain include the following. Heel Spurs. Heel spurs develop when the lining that
covers the heel is continuously stretched. When this occurs, pieces of the lining may break off. Heel spurs typically develop in athletes who frequently run or jog. They are also common in people who
are obese. Plantar Fasciitis. Plantar fasciitis develops when the tissue connecting the heel to the ball of the foot becomes inflamed. Plantar fasciitis also occurs in athletes who frequently run or
jog. It can also result from wearing shoes that do not fit properly. Excessive Pronation. Excessive pronation occurs when the ligaments and tendons at the back of the heel are stretched too much.
This condition can occur when injuries to the back, hips, or knees change the way you walk. Achilles Tendinitis. Achilles tendinitis can occur when the Achilles tendon, which runs along the back of
the heel, becomes inflamed. This condition is common in people with active lifestyles who frequently run and jog, professional athletes and dancers.
The symptoms of plantar fasciitis include pain along the inside edge of the heel near the arch of the foot. The pain is worse when weight is placed on the foot especially after a long period of rest
or inactivity. This is usually most pronounced in the morning when the foot is first placed on the floor. This symptom called first-step pain is typical of plantar fasciitis. Prolonged standing can
also increase the painful symptoms. It may feel better after activity but most patients report increased pain by the end of the day. Pressing on this part of the heel causes tenderness. Pulling the
toes back toward the face can be very painful.
Your GP or podiatrist (a healthcare professional who specialises in foot care) may be able to diagnose the cause of your heel pain by asking about your symptoms and examining your heel and foot. You
will usually only need further tests if you have additional symptoms that suggest the cause of your heel pain is not inflammation, such as numbness or a tingling sensation in your foot - this could
be a sign of nerve damage in your feet and legs (peripheral neuropathy), your foot feels hot and you have a high temperature (fever) of 38C (100.4F) or above - these could be signs of a bone
infection, you have stiffness and swelling in your heel - this could be a sign of arthritis. Possible further tests may include, blood tests, X-rays - where small doses of radiation are used to
detect problems with your bones and tissues, a magnetic resonance imaging (MRI) scan or ultrasound scan, which are more detailed scans.
Non Surgical Treatment
When consulting a doctor about heel pain, a patient can expect to be questioned about their level of pain, how long they?ve been experiencing it, and which activities aggravate or alleviate the
condition. The doctor may order x-rays, a physical therapy regimen, or refer the afflicted individual to an orthopedic specialist for further examination. The doctor may attempt to recreate
conditions that cause the heel pain to flare up in order to study reaction and cause in the patient, but this will be temporary and the doctor will stop this test at the request of the patient. A
patient with heel pain may also be fitted with special inserts for their shoes to help correct arch and heel problems that cause pain. Heel problems can range from the mildly irritating to the nearly
devastating, but proper prevention in care will help keep each step pain free. Advanced orthopedics, pain management, and technologically-honed surgical techniques ensure that no patient needs to
suffer with the discomfort of heel pain and the restrictions it imposes on an active lifestyle.
When a diagnosis of plantar fasciitis is made early, most patients respond to conservative treatment and don?t require surgical intervention. Often, when there is a secondary diagnosis contributing
to your pain, such as an entrapped nerve, and you are non-responsive to conservative care, surgery may be considered. Dr. Talarico will discuss all options and which approach would be the most
beneficial for your condition.
You can help to prevent heel pain by maintaining a healthy weight, by warming up before participating in sports and by wearing shoes that support the arch of the foot and cushion the heel. If you are
prone to plantar fasciitis, exercises that stretch the Achilles tendon (heel cord) and plantar fascia may help to prevent the area from being injured again. You also can massage the soles of your
feet with ice after stressful athletic activities. Sometimes, the only interventions needed are a brief period of rest and new walking or running shoes.