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What Causes Heel Pain?

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. A foot and ankle surgeon is best trained 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.heel pain

Symptoms of Plantar Fasciitis Heel spur
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.

Causes of Plantar Fasciitis
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 a person's job requires long hours on their feet. Obesity also contributes to plantar fasciitis.

Diagnosis
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, a bone scan, or magnetic resonance imaging (MRI) 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.

Treatment Options
Treatment of plantar fasciitis begins with first-line strategies, which you can begin at home:

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. Putting an ice pack on your heel for 10 minutes several times a day helps reduce inflammation. 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. Your shoes should provide a comfortable environment for the foot.
Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help reduce pain and inflammation.
Lose weight. Extra pounds put extra stress on your plantar fascia.

If you still have pain after several weeks, see your foot and ankle surgeon, who may add one or more of these 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 pla ntar fasciitis.
Injection therapy. In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain.
Removable walking cast. A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal.
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.

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. Your foot and ankle surgeon will discuss the surgical options with you and determine which approach would be most beneficial for you.

Long-Term Care

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. If you are overweight, it is important to reach and maintain an ideal weight. For all patients, wearing supportive shoes and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.

You can call Austin Foot and Ankle Specialists at (512) 328-8900, or come visit our office, conveniently located at:
5000 Bee Cave Road
Suite 202
Austin, TX 78746.

Blog for Heel and Arch Pain

Library for Heel and Arch Pain:

When Can I Run Again after a diagnosis of Achilles Tendinitis?
Achilles Tendinitis is a common condition found in both athletes & non athletes alike when a sprain and strain occurs within the fibers of the achilles tendon.
Tarsal Coalitions
A tarsal coalition is an abnormal connection of bone that develops between the two bones of the heel where symptoms usually occur between 9 and 12 years of age.
Equinus - Tightness of the Heel Cord
Equinus is a condition where the tightness of the muscles of the achilles tendon become the most deforming force of the foot. This may often lead to heel pain.
Cavus Foot - High Arch Foot
A Cavus foot is a high arched foot that is fixed in position that often is difficult to fit and size shoes. Heel pain and ball of foot pain are common concerns.
Haglund’s Deformity / “Pump-Bump”
Haglund's deformity is a condition when the bone on the back of the heel becomes enlarged making it painful and difficult to wear closed heeled shoes.
Posterior Tibial Tendon Dysfunction (PTTD)
Posterior Tibial Tendon Dysfunction (PTTD) is a condition that is frequently treated by the surgeons at Austin Foot and Ankle Specialists, call us 512-328-8900.
Orthotic Technology. Why we prefer Total Contact Orthotics.
There are really only two general categories of functional orthotic technologies.
Custom Orthotics Provide the Prefect Fit
Are custom orthotics right for you? Read this article to learn more and call our offices in Austin, TX to speak with one of our doctors. (512) 328-8900.
Orthospec ESWT Therapy for Chronic Heel Pain
Orthospec therapy is a safe and effective alternative to invasive surgical treatments. Call Austin Foot and Ankle Specialists for more information.
PodiaTherm Offers New Treatments for Heel Pain
Do you suffer from chronic heel pain? Our new PodiaTherm technology may be able to offer you new diagnosis or treatments.
Orthotic Wearing Instructions
Follow these instructions for starting to wear custom orthotics to treat a Texas running or sports injury. Call the Austin Foot and Ankle Specialists.