The most common cause of heel pain is plantar fasciitis. It is sometimes referred to as heel spur syndrome, though no bone spurs develop due to this condition. Usually, faulty foot structure causes a strain on the fibrous connective tissue that stretches along the bottom of your foot from your heel to your toes. This band of connective tissue is called the plantar fascia, which becomes inflamed and irritated by excessive strain. Dull or sharp pain can be present with plantar fasciitis.
Usually, pain begins gradually in plantar fasciitis and often affects only one foot. The pain can be present in the heel or the arch of your foot, being worse during the first steps of morning. Also, heel pain may be initiated after lengthy periods of sitting or standing. Shoes with poor arch support can aggravate plantar fasciitis. Sometimes, mild foot swelling and redness may occur. Ignoring symptoms of plantar fasciitis may lead to a change in your walking biomechanics and secondary development of foot, knee, hip or back problems.
Causes and Risk Factors
Since the plantar fascia acts as shock absorbing tissue in the arch of your foot, increased tension on this arch area can cause excess stretching and tearing of the tissue. Certain types of exercise, such as ballet, long-distance running and volleyball, have a tendency to place excessive strain on the plantar fascia, thus causing plantar fasciitis. The risk of developing plantar fasciitis increases with age, weight gain and improper shoe support. Also, occupations requiring hours of walking or standing cause increased incidence of plantar fasciitis.
Your physician has the ability to diagnosis plantar fasciitis with a complete history and examination of your foot. He will check your foot’s musculoskeletal and neurological functions by testing muscle strength, tone, and reflexes, as well as sense of touch, coordination and balance. Sometimes, X-rays or magnetic resonance imaging may be prescribed by your physician to rule-out other conditions with similar symptoms.
Early plantar fasciitis treatment options include anti-inflammatory medication, stretching exercises, rest, cold therapy and arch support. Sometimes, a topical corticosteroid ointment is prescribed for use on the affected area of plantar fasciitis. Corticosteroid injections are not commonly used because they can cause further fascia damage. If symptoms do not resolve, physical therapy, night splints or orthotics may be prescribed. Orthotics can be used in your shoes or during sleep. As a last resort, shock wave therapy or surgery is needed to eliminate the pain caused by plantar fasciitis.
Prognosis is good for eliminating plantar fasciitis. Nonsurgical methods usually resolve heel pain, although treatment can last several months before your symptoms resolve. Most patients need about nine months to become pain-free. Surgical treatment is usually not necessary for plantar fasciitis.
Other Conditions Causing Heel Pain
Heel pain can be caused by other conditions than plantar fasciitis. Achilles tendonitis, heel bursitis, Haglund’s deformity, and bone spurs can cause heel pain. Inflammation of the Achilles tendon or heel bursa, a small sack of fluid under your heel bone, can cause pain similar to plantar fasciitis. Haglund’s deformity and bone spurs cause bony changes on the heel that can become irritated and inflamed. Appropriate diagnostics performed by your physician should discriminate between plantar fasciitis and these other conditions.