Heel Pain

Heel Pain:

In this post you will find information and treatment recommendations for Heel Pain or Plantar Fasciitis. Heel pain is a very common problem. There are several diiferent conditions that can cause pain in the heel. We will discuss each separately. Most heel pain develops over time and is more of a chronic problem If you experience a sudden onset of pain anywhere in your heel, with an associated event or limit in function, then seek immediate medical care with a physician.

PLANTAR FASCIITIS AND HEEL SPURS

As already mentioned, most heel pain is a chronic, slow developing problem that may suddenly become more painful. Plantar fasciitis is a common buzz word out there when discussing heel pain. Plantar fasciitis is the inflammation of this big ligament on the bottom of the foot, where it attaches to the heel bone. In most situations the pain is under the heel bone, but the pain and inflammation may extend along the fascia out towards the arch.

Plantar Fasciitis is described as severe pain in the bottom of the heel, sometimes also on the inside of the heel. It is often most severe when first getting out of bed in the morning or after getting up out of a chair or car seat, after sitting for a period of time. This happens because at rest, the fascia can tighten, and then scar down in sense, in that tightened position. Then when getting up the weight of the body stretches the scared down fascia, pulling on it and thus, causing a lot of pain. Althought this may subside after a few minutes, the fascia continues to be stressed every step the rest of the day and may become painful or achy all day.

Treatment

1) Arch Support and Shoes: Avoid repetitive trauma to the fascia by protecting it with good arch support during all waking hours. This can be achieved with good shoes and good arch supports. Like most injuries it is helpful to protect it all the time, so avoid barefeet, even around your home. Anytime you are not protecting it, you are stressing it even more, reducing the healing. Appropriate arch supports can be found by clicking on the "Helpful Foot Pain Products " link found above.

2) Night Splint: the morning pain is often severe and can be considered a form of trauma. To prevent the fascia from tightening and scaring down in that tightened position, the use of a night splint can be very helpful. It holds the foot up while sleeping. This not only helps reduce morning pain, but also, reduce the repetitive injury that occurs everytime you get out of bed. This is important to address because right now everytime you get out of bed you are injuring this area, and nothing gets better when it is re-injured everyday. A night splint can greatly help with this. An appropriate night splint can be found by clicking on the "Helpful Foot Pain Products" link found above

3) Stretching: Tightness in the fascia and the calf muscle/achilles needs to be addressed. In many situations, it is the calf tightness that often sets people up to develop heel pain in the first place. So you must stretch. Stretching exercises for the calf like runners type stretch up against the wall, or with heel hanging below the edge of a step, can be helpful. Also, the Pro Stretch device can very helpful. It can be found by clicking on the "Helpful Foot Pain Products"link found above.

4) Ice Massage: Ice is known to be a good anti-inflammatory. Massaging ice can be more effective in penetrating through the thick fat pad under the heel, as compared to just an ice pack or ice in a bag. Ice massage can be done 2-3 times per day for 20-30 min., no longer. Do this for 2-4 weeks, then switch to heat. The Ice Cup Devices and the Personal Foot Spa Heat products can be found by clicking on the "Helpful Foot Pain Products" link found above.

Plantar fasciitis will not resolve over night, but if you follow the above treatments for as long as it takes you will eventually have success. Be patient as it may take several months.

HEEL SPURS:

What is a heel spur? A heel spur is a calcium build up on the bottom of the heel bone. It is actually the calcification of the attachment of the plantar fascia. So heel spurs are associated with plantar fasciitis. The treatment is exactly the same. So review the above recommendations. The only way to get rid of a heel spur is through surgery, but if you treat the inflammation by doing everything discussed above in the plantar fascia section, you may be able to resolve the pain without surgery. Surgery is only considered if the above treatments have been done for many months and failed. Prior to surgery the physician you see may consider other things, such as cortisone type injections, NSAIDS, or physical therapy.

A heel spur can be seen in the xray below.

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