Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely, a cyst.
Because there are several potential causes, it is important to have heel pain properly diagnosed. At Council Bluffs Foot & Ankle Care, we are able to distinguish between all the possibilities and determine the underlying source of your heel pain.
What Is Plantar Fasciitis?
Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain.
The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fasciitis.
Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when one’s job requires long hours on the feet. Obesity may also contribute to plantar fasciitis.
The symptoms of plantar fasciitis are:
- Pain on the bottom of the heel
- 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.
If you are having heel pain, we would recommend that you make an appointment to see us. Initially, we will perform a complete and thorough examination of your foot structure. We will also perform a comprehensive biomechanical examination to see what role your foot function contributes to your condition. Digital x-rays are often taken to look for things such as a heel spur formation or stress fracture.
Treatment of plantar fasciitis often begins with many first-line strategies:
- Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery.
- Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia.
- Ice/Heat. Putting an ice pack on your heel for 20 minutes several times a day helps reduce inflammation. Place a thin towel between the ice and your heel; do not apply ice directly to the skin. Applying heat can also be helpful however to help increase blood flow in cases of chronic plantar fasciitis.
- Limit activities. Cut down on extended physical activities to give your heel a rest.
- Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia.
- Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
When we see you in the office, we may add one or more of these treatment approaches:
- Padding and strapping. Placing pads in the shoe softens the impact of walking. Strapping helps support the foot and reduce strain on the fascia.
- Orthotic devices. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis. Learn more
- EPAT Shockwave Treatment. A new treatment available at our office that helps to increase blood flow and enhance metabolism to the injured and inflamed plantar fascia tissue. Learn more
- Injection therapy. In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain.
- Night splint. Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some patients.
- Physical therapy. Exercises and other physical therapy measures may be used to help provide relief.
When Is Surgery Needed?
Although most patients with plantar fasciitis respond to non-surgical treatment, a small percentage of patients may require surgery. If, after several months of non-surgical treatment, you continue to have heel pain, surgery will be considered. We will discuss the surgical options with you and determine which approach would be most beneficial for you.
No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. Wearing supportive shoes, stretching, and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.
At Council Bluffs Foot & Ankle Care, our physicians are experts in the treatment of this painful condition. If you suffer from heel pain, it is important to seek professional treatment so you can start living your life pain-free again. Call or text us today to make an appointment for relief!