Heel pain is a common foot condition. It's usually felt as an intense pain when using the affected heel. Heel Pain
builds up gradually and gets worse over time. The pain is often severe and occurs when you place weight on the heel. In most cases, only one heel is affected, although estimates suggest that around a
third of people have pain in both heels. The pain is usually worse first thing in the morning, or when you first take a step after a period of inactivity. Walking usually improves the pain, but it
often gets worse again after walking or standing for a long time. Some people may limp or develop an abnormal walking style as they try to avoid placing weight on the affected heel.
Many things can cause heel pain. Most commonly seen at our Troy, MI office are heel spurs, which are small growths on the heel bone. Heel pain can be caused from heavy activities and increased weight
that put extra pressure on feet. Dr. Weinert often treats heel pain in athletes, runners and women who are pregnant. There are other cases where Dr. Weinert has related a patient?s heel pain to
arthritis, stress fractures, fractures, bone tumors, cysts, achilles tendonitis and Haglund's deformity. The main cause of heel pain is usually a biomechanical problem in the foot and it?s, in a
nutshell, having a foot out of alignment. There are numerous conditions. One of the most prevalent is called talotarsal dislocation syndrome. What that is in lay terms is you?ve just got a
misalignment of your ankle on your heel and as you bear weight you?re getting a collapse of the ankle on the heel causing the foot to be out of alignment. So the plantar fascia, bones, joints, and
ligaments receive constant stress. This stress occurs at the point where the plantar fascia (the major tissue that connects your toes to your heel) meets the heel. Many patients explain the pain as
being in the middle of the inside of the heel. As a patient bears weight, they get the collapse of the foot and that ligament pulls. And if you think of a rubber band constantly getting pulled on
that area of the insertion on the heel, you eventually start getting some micro tears in that ligament and causing inflammation and pain specifically right there in middle area of the heel. Plantar
fasciitis is also a common source of heel pain. The plantar fascia, a band of tissue that runs from your heel to your toes, can become strained and inflamed due to overuse and wear and tear. This
band of tissue can only withstand so much pressure and when it gives way, the pain can be severe and requires immediate and effective treatment.
Symptoms include a dull ache which is felt most of the time with episodes of a sharp pain in the centre of the heel or on the inside margin of the heel. Often the pain is worse on first rising in the
morning and after rest and is aggravated by prolonged weight bearing & thin soled shoes.
The diagnosis of heel pain and heel spurs is made by a through history of the course of the condition and by physical exam. Weight bearing x-rays are useful in determining if a heel spur is present
and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors or evidence of soft tissue damage caused by certain connective tissue disorders.
Non Surgical Treatment
Treating plantar fasciitis in the early stages usually allows for a quicker recovery. Left untreated, this condition can progress to the point where there is pain with each and every step. This
typically means a return to a pain free day will take much longer. Initial treatments are aimed at reducing stress on the fascia so it can begin to heal. Also, treatment to reduce the associated
inflammation is started. These treatments often include: ice therapy, anti-inflammatory medications, stretching exercises, wearing shoes with appropriate support, taping of the foot and the use of a
night splint. If these interventions do not lead to a full resolution, custom shoe inserts, cortisone injections and additional treatment by a physical therapist are often utilized. For patients that
fail to respond to all of these efforts, surgical release of the plantar fascia can be a very effective course of action. The good news is this: 95% of the time plantar fasciitis can be fully
resolved without the need for surgery. High energy shock wave therapy, sometimes referred to as orthotripsy, is a relatively new treatment that has been shown to be effective 70% of the time in
patients that continue to have pain despite extensive non-surgical treatment.
Only a relatively few cases of heel pain require surgery. If required, surgery is usually for the removal of a spur, but also may involve release of the plantar fascia, removal of a bursa, or a
removal of a neuroma or other soft-tissue growth.
Make sure you wear appropriate supportive shoes. Don't over-train in sports. Make sure you warm up, cool down and undertake an exercise regime that helps maintain flexibility. Manage your weight,
obesity is a factor in causing plantar fasciitis. Avoid walking and running on hard surfaces if you are prone to pain. You should follow the recognized management protocol "RICED" rest, ice,
compression, elevation and diagnosis. Rest, keep off the injured ankle as much as possible. Ice, applied for 20 minutes at a time every hour as long as swelling persists. Compression, support the
ankle and foot with a firmly (not tightly) wrapped elastic bandage. Elevation, keep foot above heart level to minimize bruising and swelling. Diagnosis. Consult a medical professional (such as a
Podiatrist or doctor) especially if you are worried about the injury, or if the pain or swelling gets worse. If the pain or swelling has not gone down significantly within 48 hours, also seek
treatment. An accurate diagnosis is essential for proper rehabilitation of moderate to severe injuries.