Heel Pain (Plantar Fasciitis)

Heel Pain

Definition

Plantar Fasciitis is the most common cause of heel pain due to inflammation of the origin of the plantar fascia. Excess traction and inflammation is caused by over-stretching of the fascia. A bone spur is formed if excess traction repeatedly occurs as the body responses to try and firmly attach the fascia to the bone.

Symptoms

The patient feels dull ache most of the time in the plantar calcaneal area due to weight bearing. The pain is felt worst on the first rising in the morning and after rest as the plantar fascia is more inflexible at those times. Many patients describe the condition to be the result of a stone bruise or a recent increase in daily activity. The pain can be reduces when resting but can be re-occurred with activities. Surveys in USA indicates that higher incidence of heel pain occurs in people who are overweighed and with sedentary lifestyle.

Biomechanical etiology

Excess subtalar joint pronation causes the arch structure to lower, the foot to elongate and adding traction force on the plantar fascia. When this sequence continues to occur over time, inflammation of the fascia and the surrounded tissues occurs. This causes ache in the arch and heel. A bony growth on the calcaneal tuberosity is developed when traction of the plantar fascia from the calcaneal tuberosity continues to occur. This bony growth is called “heel spur” which causes a sharp pain right in the center of the heel. Often, tight calf muscles aggravate the pain and dorsiflexing at the level of the ankle is limited during the propulsive phase of gait which further results in the foot dorsiflexing at the midtarsal joint. Therefore this causes the extra strain on the plantar fascia.

Treatment

The treatment for heel pain usually begins with adjustments to the shoewear to reduce symptoms. Orthotics like the Stabilizer Insoles may help to reduce the pressure on the plantar fascia. The process assists in rising the arch of the foot and therefore plantar fascial tension will be released. Anti-inflammatory medications can be used to decrease the inflammation in plantar fascia which in turn reduces the pain. Surgery is rare in treating the heel pain. It usually involves in removing the present bon spur, releasing the plantar fascia from the heel bon and reducing pressure on the small nerves under the plantar fascia.

Additional Treatment

Inflammation can be minimized by application of ice to the heel area. In addition, electrotherapeutic modalities are also performed in reducing the pain.

Exercises

Plantar Fascia stretches, toe raises and calf muscles stretches.