Heel Pain, Heel Spurs and Plantar Fasciitis

 

Overview

Heel pain is the primary foot problem reported to podiatrists, and there are literally thousands of sufferers seeking relief from this debilitating condition. Fortunately, most cases of heel pain are highly treatable without medical intervention.
Symptoms: The most common symptom with this condition is heel pain that tends to be most acute first thing in the morning or upon standing after long periods of repose.

Causes

Plantar Fasciitis is the most common cause of heel pain and heel spurs. It is caused when inflammation of the plantar fascia develops, and over-pronation of the feet is the one of the most common underlying issues associated with the development of PF.
Treatment: Specialized exercises and stretching routines, combined with the use of orthotics, is one of the most effective and frequently used treatment approaches.

Symptoms

Pain symptoms associated with plantar fasciitis and heel spurs are most severe in the morning upon waking, when the first few steps of the day are taken. This type of discomfort often presents as a stabbing pain in the heel bone. The pain may occur at the bottom of the bone or the front of the front of the bone. The level of discomfort experienced is different for every person but most sufferers find there is an increase in pain levels when there has been a notable reduction in activity levels (such as sleeping or sitting down for a long time). The stabbing generally subsides into a dull ache after the first few steps have been taken.

Why Do My Heels Hurt?

While there are several reasons why heel pain and heel spurs may develop the most common underlying cause of both conditions is plantar fasciitis. When the plantar fascia (the thick, fibrous band of tissue connecting the heel bone to the toes through the arch of the foot) becomes irritated and inflamed it can eventually lead to the development plantar fasciitis. While healthy fascia is flexible and strong, excessive pressure, obesity, and sub-par foot functioning can all cause micro-tears to develop in the tissue, which causes this irritation and inflammation to develop.

The pain is usually most severe after a period of rest as the fascia tightens up and becomes shorter when it’s not being used, and when the sudden pressure of body mass is placed upon the cold fascia it is forced to abruptly stretch and lengthen. It is this sudden and violent stretching that causes micro-tears to occur, and the resulting tears cause the searing pain often experienced first thing in the morning.

This interplay of shortening and abrupt stretching causes a ‘pulling’ action on the heel bone, which may eventually create enough friction for a heel spur to develop.
There are several factors that can cause over-stretching of the plantar fascia:

• Participation in high intensity sports
• Running
• Over-pronation of the feet
• Standing or walking on hard surfaces for great lengths of time
• Being overweight
• Pregnancy
• Tight calf muscles
• Being 50+ years of age

Treatment

Cortisone Steroid Injections

Cortisone injections are a potent anti-inflammatory that is inserted directly into the heel bone and provides near-instant relief of symptoms—once the pain of the actual injection has worn off. While cortisone injections reduce pain levels it is not a cure and relief of symptoms is temporary. Cortisone treatments should be used within a larger treatment program that addresses the underlying cause of heel pain, heel spurs, and plantar fasciitis.

Shock-Wave Therapy

Extracorporeal Shock Wave Therapy has become more accessible in the last few years and it is a great alternative to surgical intervention. Shockwaves are applied to the affected area in short, intense bursts, which promotes healing in irritated and inflamed plantar fascia tissue. While this treatment is lauded for being effective it can require up to 3 or 4 months of regular treatments to be fully effective.

Surgery

Due to its invasive nature surgical intervention is only used as a last resort in cases that have failed to positively respond to traditional conservative treatments. This procedure requires the surgeon to make an incision in the ligament in order to release the plantar fascia, which also releases the extra pressure. Bone spurs also removed during this procedure.

Conservative Treatments

Conservative self-treatment is by far the preferred option when it comes to dealing with heel pain, heel spurs, and plantar fasciitis. This type of treatment option should be considered before medical attention is sought, as many of the treatments listed below are accessible, affordable, and highly effective. It’s best to start treatment as early as possible, as this shortens the healing time and makes these steps more effective.

Rest/Reducing Activity Levels

The first thing that should be done is reducing the amount of time spent playing sports or engaging in physical activity as well as the time spent walking or standing in on spot for long periods of time. The feet need time to recover and heal, and this means that they should not be placed under continuous or intense pressures. Avoid any activity that places intense or protracted amounts of tension on the feet.

NSAIDS

Non-steroidal anti-inflammatory drugs will reduce inflammation in the feet, providing more of an opportunity for the tissues to repair themselves while reducing the pain associated with heel pain. NSAIDS should not be viewed as a long term solution however, and directions on the packaging should be strictly adhered to.

Ice Therapy

Applying ice or an ice pack to inflammation often reduces both the swelling and the pain. The ice pack should be applied directly to the heel for 10-15 minutes every 2-3 hours until symptoms improve. Care should be taken not to damage the skin by an over-application of ice.

Therapeutic Stretching and Exercise

Tight calf muscles can pull on the Achilles tendon and cause excessive tension to occur at the back of the heel; it can also negatively impact natural walking patterns and cause over-pronation to develop in one or both feet. Gentle stretching and muscle warming exercises can re-establish flexibility in the muscles of the leg and feet, which can ease excessive pressure and the resulting pain.

Foot Support and Orthotics

Orthotic devices are the gold standard when it comes to treating heel pain, heel spurs, and plantar fasciitis. Although they are best used in a comprehensive treatment plan the use of orthotics is practically mandatory as they treat the underlying cause of the problem and not just the pain symptoms. Dr Foot orthotic devices were created by a podiatrist to correct sub-par mechanics of the foot and to fully and effectively support the arches as well. By addressing the underlying issue Dr Foot orthotics relieve excessive pressures on the plantar fascia, which allows the problem to heal itself.

Dr Foot orthotics are used throughout North America and the United Kingdom and have provided relief for many thousands of people suffering from heel pain, heel spurs, and plantar fasciitis. Plantar fasciitis is a common condition but with enough care and attention it is also avoidable, and anyone who has suffered from this painful affliction is well aware that an ounce of prevention really is worth a pound of cure!

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