Heel pain is a common foot condition. It's usually felt as an intense pain when using the affected heel. Heel pain usually builds up gradually and gets worse over time. The pain is often severe and
occurs when you place weight on the heel. In most cases, only one heel is affected, although estimates suggest that around a third of people have pain in both heels. The pain is usually worse first
thing in the morning, or when you first take a step after a period of inactivity. Walking usually improves the pain, but it often gets worse again after walking or standing for a long time. Some
people may limp or develop an abnormal walking style as they try to avoid placing weight on the affected heel.
Plantar fasciitis can develop when your feet roll in too far as you take each step. This rolling in, known as over-pronation, can happen for many reasons. It can be due to excessive weight gain,
pregnancy, quickly increasing physical activity, tight calf muscles, poor biomechanics or merely wearing unsupportive, flat footwear. When your feet over-pronate, your arches can collapse, putting
strain on the tissues in the bottom of your foot.
People with this condition sometimes describe the feeling as a hot, sharp sensation in the heel. You usually notice the pain first thing in the morning when you stand. After walking for a period of
time, the pain usually lessens or even disappears. However, sharp pain in the center of the heel may return after resting for a period of time and then resuming activity.
A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose plantar fasciitis. Occasionally, further investigations such as an X-ray, ultrasound or MRI
may be required to assist with diagnosis and assess the severity of the condition.
Non Surgical Treatment
Treatment of heel pain caused by plantar fasciitis begins with simple steps. There are a number of options for treatment of plantar fasciitis, and almost always some focused effort with nonsurgical
treatments can provide excellent relief. In rare circumstances, simple steps are not adequate at providing relief, and more invasive treatments may be recommended. Typically, patients progress from
simple steps, and gradually more invasive treatments, and only rarely is surgery required.
In unusual cases, surgical intervention is necessary for relief of pain. These should only be employed after non-surgical efforts have been used without relief. Generally, such surgical procedures
may be completed on an outpatient basis in less than one hour, using local anesthesia or minimal sedation administrated by a trained anesthesiologist. In such cases, the surgeon may remove or release
the injured and inflamed fascia, after a small incision is made in the heel. A surgical procedure may also be undertaken to remove bone spurs, sometimes as part of the same surgery addressing the
damaged tissue. A cast may be used to immobilize the foot following surgery and crutches provided in order to allow greater mobility while keeping weight off the recovering foot during healing. After
removal of the cast, several weeks of physical therapy can be used to speed recovery, reduce swelling and restore flexibility.
Preventing plantar fasciitis is crucial. There are many choices to help prevent the occurrence of this condition, and keep it from returning. One of the most important is maintaining a healthy weight
in order to reduce tension on the plantar fascia. In addition, shoes are very important, and should fit well and provide ample cushioning and support throughout the heel, arch, and ball of the foot
so that weight is distributed evenly throughout the foot. Try to avoid walking barefoot on hard surfaces and replace old shoes before they wear out, especially shoes that you run or exercise in. When
exercising, start off slow and ease into new routines to prevent sudden or excessive stress on tissue. Lastly, keep your calf muscles and the tissue of your feet stretched. Greater flexibility in the
tissue makes them less susceptible to damage.