Heel Pain (Heel Spur)


Introduction to Heel Pain



The most common cause of heel pain is plantar fascitis which is commonly referred to as a heel spur. Plantar fascia is a broad band of fibrous tissue which runs along the bottom surface of the foot, from the heel to the toes. Plantar fascitis is a condition in which the plantar fascia is inflamed. This condition can be very painful and cause considerable amount of suffering.

Long standing inflammation causes the deposition of calcium at the point where the plantar fascia inserts into the heel. This results in the appearance of a sharp thorn like heel spur on x-ray. The heel spur is a-symtomatic (not painful), the pain arises from the inflammation of the plantar fascia. Symptoms include a dull ache which is felt most of the time with episodes of a sharp pain in the center 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.



Causes of Heel Pain




·         Excessive load on the foot from obesity is a major cause of plantar fascitis. Which is why this condition is common in middle aged and over weight adults.

·         A sudden increase in weight, such as pregnancy can also lead to plantar fascitis.

·         A sudden increase in walking or a sporting activity can also be a contributing factor. A classical example is a post man who has returned to work after a period away from the job can develop this condition.

·         Tight plantar fascia (this is often caused by tight calf muscles).

·         Excessive flattening of the arch on weight bearing.

·         Biomechanical problems (walking abnormalities) is a major cause of plantar fascitis.

·         Different types of arthritis can also lead to this condition such as osteoarthritus and rheumatoid arthritis.



Treatments for Heel Pain



·         Orthotics- One of the most effective treatment options, view the Dr Foot Pro Insoles.

·         Silicone Heel Cups- Treats morning heel pain and provides excellent support and pain relief.

·         Reusable Hot and Cold Gel Packs- Proven therapy for plantar fasciitis by alternating application of heat and cold coupled with massage works wonders to relieve pain, reduce swelling and promote healing. Use ice pack in morning and heat pack in the evening.

·         Plantar Fascia Night splints- Immobilize and stretch fascia, can be effective if used for several weeks.

·         Stretching exercises for plantar fascia and Achilles tendon - Can provide effective results if combined with other treatment options.

·         Stretching aids- The Pro Stretch stretches the foot in the proper position to relieve heel pain,

·         Ultrasound and Lasers- Found to have little or no benefit.

·         Extracorporeal shock wave therapy (ESWT)- Their are differing views about the safety and effectiveness of this treatment.

·         NSAIDs (Non Steroidal Anti-Inflammatory Drugs)- These treat the symptoms and provide temporary relief but do not treat the underlying cause. Observe usual cautions and contraindications as these can have long term implications on your health.

·         Steroid/local anesthetic injection- Not one of our preferred treatment options,

·         Surgery- 'Open' or endoscopic plantar fascia release. No good evidence of effectiveness, and complications include increased pain, nerve injury, fascial rupture and infection. May need to consider in resistant cases after trying night splints and a walking brace


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