Guide to Heel Pain, Heel Spurs and Plantar Fasciitis

 

Overview

Symptoms: Typical symptoms include heel pain that is most pronounced upon waking.

Causes: Plantar Fasciitis is the most common cause of heel pain. This condition occurs when the plantar fascia becomes inflamed. Irritation and inflammation of the plantar fascia often occurs as a result of over-pronation of one or both feet.

Treatment: Effective front-line treatment includes stretching exercises and the use of special insoles.

Symptoms

Heel pain and heel spurs that occur due to plantar fasciitis often cause acute discomfort first thing in the morning when the patient initially gets out of bed. This type of pain is often described as ‘sharp’ and ‘stabbing’, and it is usually felt at the bottom of the heel bone, though it can develop at the front of the heel bone as well.

The level of discomfort experienced by each person is unique, though most people find that the pain is worse after extended periods of inactivity (sleeping through the night, after sitting down for a long time, etc.). Most sufferers find that this initial discomfort subsides once they get up and begin moving around. While the sharp pain subsides after the muscles of the foot ‘warm up’ it is typically replaced with a dull, aching pain.

Why Exactly Does It Hurt?

Heel pain and heel spurs are usually caused by plantar fasciitis, which is a painful condition causes by inflammation of the plantar fascia.

The plantar fascia is fibrous band of tissue that runs through the arch of the foot, connecting the toes to the heel bone. When it is healthy the fascia is both supple and strong, but if it is exposed to excessive pressures for extended periods of time—such as sub-par mechanics of the foot, excess body weight, or the aging process in general—it may cause micro-tears to develop in the tissue. This leads to inflammation of plantar tissues and the development of plantar fasciitis.

The plantar fascia becomes tighter and begins to ‘shorten’ during periods of inactivity, and when an abrupt introduction of body weight is applied to the tendon it rapidly stretches in order to ‘lengthen out’ again. The micro-tears that develop as a result of this ‘stretching out’ are responsible for the stabbing pain that occurs in sufferers of PF when they first get out of bed in the morning and begin to walk.

This abrupt stretching and ‘flattening out’ of the plantar fascia means that there is constant pressure being applied to the heel bone, and this constant pulling often leads to the development of a hard growth on the heel, which is referred to as a heel spur.

What Causes Over-Stretching of Plantar Fascia to Occur?

The type of over-stretching that often leads to the development of plantar fasciitis may occur for a number of reasons. Some of the risk factors include:

• Over-pronation in one foot or both feet
• Standing or walking on hard surfaces for extended periods of time
• Being overweight or pregnant
• Regular, intense physical activity such as running and/or playing sports
• Being 50 years of age and older
• Having tight calf muscles

Conservative Treatments

Treatment of heel pain and plantar fasciitis often begins at home, as there many affordable and accessible treatment options that can be tried before consulting a doctor or podiatrist. The following suggestions have proven successful in the conservative treatment of heel pain and PF, particularly when undertaken immediately after symptoms first present. Early intervention makes these options more effective and gives results much sooner than if the condition is allowed to deteriorate.

Rest / Reduce Activity Levels

It is important to remove as much body weight (and therefore pressure) from the plantar fascia as possible so that it has time to heal. This means taking a rest period from intense physical activity levels and walking and standing as little as possible. Running, playing sports, and walking for extended periods of time should be avoided.

Anti-Inflammatory Medication

Over the counter non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin or ibuprofen reduce inflammation in the fascial tissues and provide relief of pain symptoms. Anti-inflammatory drugs are not a cure-all however, and should be used in a broader treatment context.

Cold Therapy

The liberal use of ice packs often reduces inflammation and pain symptoms as well. Applying an ice pack to the heel for 5 minutes on, 1 minute off is often an effective treatment. Care should be taken to make sure that the skin is not damaged by prolonged or direct exposure to ice (ice or ice cubes should be placed in a plastic bag and wrapped in a thin towel or cloth before being applied to the skin).

Specialized Exercises

While some physical activities should be avoided others should be embraced. Heel pain and plantar fasciitis are often caused by tight calf muscles and/or a tight Achilles tendon, which negatively impacts the gait cycle and places excessive strain on the plantar fascia. By stretching out tight muscles and developing flexibility in the feet and legs excessive pressures, and therefore pain, is usually reduced.

Foot Support Through the Use of Insoles

Insoles are one of the primary recommendations made by doctors and podiatrists as part of an effective treatment plan for heel pain and plantar fasciitis. While a large part of treating this condition is the reduction of inflammation and pain management insoles also address the underlying problem, which is absolutely essential for positive results.

Faulty biomechanics of the foot are one of the primary causes of heel pain and several products, such as Dr Foot Insoles, have been created by podiatrists to address these problems through proper arch support and the correction of these faulty mechanics. This type of correction reduces the pressure placed on the plantar fascia which in turn reduces the level of inflammation, effectively allowing the irritated tissues to heal on its own. Dr Foot Insoles are used by doctors, chiropodists, podiatrists, and physiotherapists throughout the UK and are a proven, reliable product responsible for reducing heel pain in thousands of patients.

View Insoles for Heel Pain

Medical Treatment

When heel pain and plantar fasciitis do not respond positively to conservative treatments medical intervention may be required. These are the most common forms of medical treatment used to treat stubborn cases of heel pain and PF.

Cortisone-Steroid Injections

Cortisone steroid injections are a potent anti-inflammatory that are injected directly into irritated tissues. The pain may briefly intensify after the shot is given but this is generally followed by an immediate relief of symptoms. There may be discomfort from the shot itself and the pain relief is temporary, so these injections must also be used in a broader treatment plan, as they will not cure the underlying condition that caused the problem in the first place.

Extracorporeal Shock Wave Treatment

Shockwave therapy uses sound waves to treat heel pain and plantar fasciitis. The positive effects are not always immediately apparent and this process may have to be undertaken for several months in order to be completely effective. It has nonetheless grown in popularity as a treatment option, particularly amongst patients who might otherwise be facing surgery to treat stubborn cases of heel pain.

Surgery

Surgery is used a last resort for stubborn cases that have not responded to conservative treatments or medical treatments, and it is reserved for severe cases only. Surgery generally entails release of the plantar fascia made through an incision in the foot, and bone spurs are usually removed at the same time.

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