HEEL PAIN "PLANTAR FASCIITIS"

Helping Cedarhurst Heal

Heel pain is most often caused by plantar fasciitis. 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. 

What Is Plantar Fasciitis?
An inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. 

Causes
The most common cause relates to faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fasciitis.

Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to this condition. This is particularly evident when one’s job requires long hours on the feet and Obesity. 

Symptoms

• Pain on the bottom of the heel

• 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 the pain subsides but returns after spending long periods of time on their feet.

Diagnosis
To arrive at a diagnosis, we will obtain your medical history and examine your foot. Throughout this process we rule out all the possible causes for your heel pain other than plantar fasciitis.

In addition, diagnostic imaging studies such as x-rays or other advanced imaging modalities may be used. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. 

Conservative treatment

• Home Stretching exercises. Stretch out the calf muscles help ease pain and assist with recovery.

• Avoid walking barefoot. When you walk without shoes, you put undue strain and stress on plantar fascia.

• Ice. Putting an ice pack on your heel for 10 minutes several times a day helps reduce inflammation. Place a thin towel between the ice and your heel; do not apply ice directly to the skin.

• Limit activities. Cut down on extended physical activities to give your heel a rest.

• Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia.

• Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.

• Padding and strapping. Placing pads in the shoe softens the impact of walking. Strapping helps support the foot and reduce strain on the fascia.

• Orthotic devices. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis.

• Injection therapy  Corticosteroid injections are used to help reduce the inflammation and relieve pain

• Night splint. This allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain.

• Physical therapy. 

When Is Surgery Needed?
If, after several months of non-surgical treatment, you continue to have heel pain, surgery will be considered. We offer "Endoscopic Plantar Fasciotomy"