Heel pain is a common ailment and can be caused by a number of problems. The nature and severity of symptoms will range depending on the cause. Heel pain is often characterised by pain on initial weight bearing in the morning that eases after a few minutes. This pattern can be repeated during the day following short periods of rest or return while standing towards the end of the day. Heel pain causes a considerable degree of discomfort and suffering.
There are a numerous causes of heel pain, such as: Plantar fasciitis and/ or heel spurs, trauma, arthritic conditions such as rheumatoid and osteoarthritis, stress fractures, Sever’s disease, cracked heels and Nerve entrapments.
Treatment is directed by diagnosis and identifying and managing the underlying causes.
One of the most common causes of heel pain is a condition called plantar fasciitis or more commonly known as a heel spur. Plantar fasciitis occurs when the plantar fascia ligament along the bottom of the foot becomes overloaded leading to excess traction and inflammation. When the foot is rested the fascia tightens due to the inflammation. When the foot resumes weight bearing the band is stretched and produces a stabbing pain that normally eases after a few minutes. This repeated pulling on the heel bone can often lead to the formation of a heel spur, a pointy piece of bone that can be detected on X-rays. The bony spur itself rarely causes pain but the inflammation of the surrounding plantar fascia does. Excessive walking in footwear which does not provide adequate arch support has been attributed to plantar fasciitis. In addition, overweight individuals are more at risk of developing the condition.
Symptoms of Plantar Fasciitis:
Heel pain, under the heel and usually on the inside, at the origin of the attachment of the fascia. Pain when pressing on the inside of the heel and sometimes along the arch of the foot. Pain is usually worse first thing in the morning. As the condition becomes more severe the pain can get worse throughout the day if activity continues. Stretching the plantar fascia may be painful. Sometimes there may also be pain along the outside border of the heel, depending on the individual compensatory biomechanics of the foot.
Treatments for Plantar Fasciitis
Rest, if the pain was a result of a sudden increase in exercise. Weight loss. Plantar fasciitis icing and stretching of the lower leg muscles, particularly the calf and hamstring muscles. Selection of appropriate footwear. If abnormal foot mechanics are contributing to overloading the plantar fascia, foot orthoses may be indicated. Orthotics are designed to control excess and abnormal pronation which is one of the most recognised causes of this condition. In addition the material used will greatly assist in shock absorption redistributing forces from the heel bone.