The heel bone is the largest of the 26 bones in the human foot. But while it is a large, strong bone, it is often injured, and this pain can be quite disabling at times. Heel Pain
can occur in the front, back, sides or bottom of the heel. That the heel is commonly injured is not surprising,
perhaps, given the amazing amount of stress it must endure during a day. Indeed, it is one of the most common injuries of the foot; we see some variation of heel pain in our offices an average of 5
or 6 times per day.
he most common cause of heel pain is over pronation, this is when your foot rotates in too much as you walk. You really need to treat the underlying cause of the heel pain as soon as possible to
prevent any further damage to the plantar fascia. Excessive load on the foot from obesity is a major cause of plantar fasciitis. Which is why this condition is common in middle aged and over weight
adults. A sudden increase in weight, such as pregnancy can also lead to plantar fascitis. A sudden increase in walking or a sporting activity can also be a contributing factor. A classic example of
when this condition can develop is when a post man has returned to work after a period away from the job. Tight plantar fascia (this is often caused by tight calf muscles). Excessive flattening of
the arch on weight bearing i.e. flat feet. People with flat feet are more at risk of developing this condition. Biomechanical problems (walking abnormalities) is a major cause of plantar fasciitis.
Different types of arthritis can also lead to this condition, such as osteoarthritis and rheumatoid arthritis.
The symptoms of plantar fasciitis are pain on the bottom of the heel, pain in the arch of the foot, pain that is usually worse upon arising, pain that increases over a period of months. People with
plantar fasciitis often describe the pain as worse when they get up in the morning or after they?ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because
walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.
A biomechanical exam by your podiatrist will help reveal these abnormalities and in turn resolve the cause of plantar fasciitis. By addressing this cause, the patient can be offered a podiatric
long-term solution to his problem.
Non Surgical Treatment
Calf stretch, silicone Heel cups, ice, night splint, physical therapy. Sometimes custom orthotics are beneficial in long standing cases. Steroid injections have been used and although they
temporarily relieve the pain, the pain usually returns within a short period of time. Plantar fasciitis tends to go away in 90% of all people in time. It can take 12-18 months for all the pain to
resolve. If the pain continues after adequate treatment, high frequency shock wave therapy (OssaTron) has been found to be beneficial, unfortunately most insurance companies do not cover this
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.