Does your heel feel painful when you get up from bed every morning, or when you get up after sitting down for a long period of time? If you often experience this sort of pain, known as first step
pain, you could be suffering from plantar fasciitis (pronounced fash-ee-eye-tus), an inflammation of the plantar fascia, or the band of muscle under the foot. Plantar fasciitis is the most common
cause of Heel Pain
Here are a few in-depth explanations of heel pain causes and potential remedies for those that are afflicted Plantar Fascitis, One of the most well-known causes of heel pain, plantar fascitis occurs
when the thick tissue along the arch of the foot becomes tight and inflamed. The foot itself can feel cramped when this tissue is inflamed, causing the afflicted person to feel as if they have a
muscle cramp that flexing the foot doesn?t seem to alleviate. Plantar fascitis is most common among men over the age of 40. Warning Signs, The first steps in the morning are extremely painful. Pain
flares up after activities like stair or steep hill climbing. Pain continues to occur regardless of the type of shoes or lack of shoes worn.
Pain in the heel can be caused by many things. The commonest cause is plantar fascitis. Other causes include, being overweight, constantly being on your feet, especially on a hard surface like
concrete and wearing hard-soled footwear, thinning or weakness of the fat pads of the heel, injury to the bones or padding of the heel, arthritis in the ankle or heel (subtalar) joint, irritation of
the nerves on the inner or outer sides of the heel, fracture of the heel bone (calcaneum).
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
If pain and other symptoms of inflammation-redness, swelling, heat-persist, you should limit normal daily activities and contact our office, or another doctor of podiatric medicine. Your foot would
be examined, and an X-ray may be taken to rule out problems of the bone. Early treatment might involve oral or injectable anti-inflammatory medication, taping, padding, massage, stretching, exercise,
shoe recommendations, physiotherapy, over-the-counter shoe inserts or, if the condition is chronic and there is a biomechanical basis to the complaint, orthoses (or orthotic devices) may be used to
permanently take strain off the fascia. Only rarely is surgery required for heel pain. If necessary, however, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa,
or removal of a neuroma or other soft-tissue growth.
It is rare to need an operation for heel pain. It would only be offered if all simpler treatments have failed and, in particular, you are a reasonable weight for your height and the stresses on your
heel cannot be improved by modifying your activities or footwear. The aim of an operation is to release part of the plantar fascia from the heel bone and reduce the tension in it. Many surgeons would
also explore and free the small nerves on the inner side of your heel as these are sometimes trapped by bands of tight tissue. This sort of surgery can be done through a cut about 3cm long on the
inner side of your heel. Recently there has been a lot of interest in doing the operation by keyhole surgery, but this has not yet been proven to be effective and safe. Most people who have an
operation are better afterwards, but it can take months to get the benefit of the operation and the wound can take a while to heal fully. Tingling or numbness on the side of the heel may occur after
Maintaining flexible and strong muscles in your calves, ankles, and feet can help prevent some types of heel pain. Always stretch and warm-up before exercising. Wear comfortable, properly fitting
shoes with good arch support and cushioning. Make sure there is enough room for your toes.