More than 20 percent of patients visit foot specialists because of Heel Pain
, and approximately one-third of all
patients I see come because of this problem. Over 50 percent of Americans will experience heel pain during their lifetime. The most common form of heel pain is known as plantar fasciitis or "heel
spur syndrome." The plantar fascia is a thick ligament on the bottom of your foot spanning from your heel to the base of your toes. It supports the arch and several muscles under the bones that
support the foot. Overtime, most people will develop some degree of calcification within these muscles on the bottom of their heel called a "spur."
Some of the many causes of heel pain can include abnormal walking style (such as rolling the feet inwards), obesity, ill-fitting shoes eg narrow toe, worn out shoes, standing, running or jumping on
hard surfaces, recent changes in exercise program, heel trauma eg. stress fractures, bursitis (inflammation of a bursa), health disorders, including diabetes and arthritis.
Pain in the heel can be caused by many things. The commonest cause is plantar fascitis. Other causes include, being overweight, constantly being on your feet, especially on a hard surface like
concrete and wearing hard-soled footwear, thinning or weakness of the fat pads of the heel, injury to the bones or padding of the heel, arthritis in the ankle or heel (subtalar) joint, irritation of
the nerves on the inner or outer sides of the heel, fracture of the heel bone (calcaneum).
To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain
other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are
found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
Non Surgical Treatment
Rest until there is no more pain. This is the most important element of treatment as continuing to walk or run on the injured foot will not allow the injury to heal. Wear soft trainers with lots of
cushioning or pad the heel of shoes with shock absorbing insoles or heel pads. These should be worn in both shoes, even if only one heel is bruised. Wearing a raise in only one shoe causes a leg
length difference which can cause other problems. Replace running shoes if they are old. A running shoe is designed to last for around 400 miles of running. After this the mid soles are weakened
When a diagnosis of plantar fasciitis is made early, most patients respond to conservative treatment and don?t require surgical intervention. Often, when there is a secondary diagnosis contributing
to your pain, such as an entrapped nerve, and you are non-responsive to conservative care, surgery may be considered. Dr. Talarico will discuss all options and which approach would be the most
beneficial for your condition.
A variety of steps can be taken to avoid heel pain and accompanying afflictions. Wear shoes that fit well-front, back, and sides-and have shock-absorbent soles, rigid shanks, and supportive heel
counters. Wear the proper shoes for each activity. Do not wear shoes with excessive wear on heels or soles. Prepare properly before exercising. Warm up and do stretching exercises before and after
running. Pace yourself when you participate in athletic activities. Don?t underestimate your body's need for rest and good nutrition. If obese, lose weight.