Pain arises in the centre of the heel and sometimes can spread to the arch region of the foot. Some patients complain of intense Heel
when walking the first few steps in the morning and after periods of rest. The most common cause of heel pain is plantar fascitis. The plantar fascia is a broad band of tissue that runs
along the bottom of the foot. When this band of tissue is damaged due to biomechanical reasons or inappropriate running shoes then the tissue can become inflamed or even tear at the heel bone. This
can be very painful.
There are many causes of heel pain. However, plantar fasciitis, also known as heel spur syndrome, is the most common, by far. The pain is usually localized to the bottom of the heel towards the
inside of the foot. The arch may also be painful. With this condition, pain is typically most severe with the first few steps after a period of rest. The pain my then subside and then return after
extended periods of standing. There is usually no specific traumatic event that is responsible for the condition. It is usually the result of overuse, e.g. too much standing, walking or running.
There are several common contributory factors such as weight gain, foot type, shoes. Flat shoes or going barefoot are the worst. Athletic shoes are usually the best. The plantar fascia is a fibrous
band or ligament that connects the ball of the foot with the heel and helps to support the arch. When this band gets stretched too much or overused, inflammation results, often at the location where
it attaches to the heel bone. A heel spur may develop as a result of chronic pulling by the plantar fascia. However, it should be noted that the pain is not caused by the spur. In fact, in some of
the most severe cases, there is no spur at all. In other instances, an X-ray may be taken for an unrelated condition and an extremely large but non-painful spur may be seen. Other causes of heel pain
include gout, stress fracture, bone tumors, nerve entrapment and thinning of the fat pad beneath the heel. Pain at the back of the heel is usually not plantar fasciitis. (Pain at the back of the heel
is often due to an inflammation of the Achilles tendon, enlargement of the heel bone or bursitis.)
Symptoms include a dull ache which is felt most of the time with episodes of a sharp pain in the centre of the heel or on the inside margin of the heel. Often the pain is worse on first rising in the
morning and after rest and is aggravated by prolonged weight bearing & thin soled shoes.
Depending on the condition, the cause of heel pain is diagnosed using a number of tests, including medical history, physical examination, including examination of joints and muscles of the foot and
Non Surgical Treatment
Heel pain often goes away on its own with home care. For heel pain that isn't severe, try the following. Rest. If possible, avoid activities that put stress on your heels, such as running, standing
for long periods or walking on hard surfaces. Ice. Place an ice pack or bag of frozen peas on your heel for 15 to 20 minutes three times a day. New shoes. Be sure your shoes fit properly and provide
plenty of support. If you're an athlete, choose shoes appropriate for your sport and replace them regularly. Foot supports. Heel cups or wedges that you buy in the drugstore often provide relief.
Custom-made orthotics usually aren't needed for heel problems. Over-the-counter pain medications. Aspirin or ibuprofen (Advil, Motrin IB, others) can reduce inflammation and pain.
At most 95% of heel pain can be treated without surgery. A very low percentage of people really need to have surgery on the heel. It is a biomechanical problem and it?s very imperative that you not
only get evaluated, but receive care immediately. Having heel pain is like having a problem with your eyes; as you would get glasses to correct your eyes, you should look into orthotics to correct
your foot. Orthotics are sort of like glasses for the feet. They correct and realign the foot to put them into neutral or normal position to really prevent heel pain, and many other foot issues.
Whether it be bunions, hammertoes, neuromas, or even ankle instability, a custom orthotic is something worth considering.
Heel pain is commonly caused from shoes that do not fit properly. In addition, shoes need to have ample cushioning and support, particularly through the heel, ball of the foot, and arch. Shoes should
also be replaced if they become too worn. One sure sign of wear and tear is overly worn areas of a shoe's insoles. If the heel or ball of the foot is particularly worn, damage could easily occur
since the bottom of the foot is not getting the cushioning it needs.