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
able to distinguish between all the possibilities and determine the underlying source of your heel pain. 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.
Age plays a large role in the development of heel pain, particularly among those over 40. Being active is also a common factor of heel pain. Over time, the elasticity of the tissue in our feet
decreases with age, causing us to become prone to damage and also slowing the body's ability to heal damage. Adolescents are also not immune to heel pain. Those who are active in sports are
particularly prone to excessively stretching or straining the plantar fascia or Achilles tendon, causing severe heel pain. In most cases, heel pain develops in only one heel. There are many risk
factors that lead to heel pain. Abnormal gait and excessive, repetitive stress are common factors in the development of pain and damage. Among the other risk factors involved with the development of
heel pain are repetitive exercise or activities, such as long distance running or jumping from activities such as basketball. Obesity. Walking barefoot on hard surfaces. Prolonged standing. Wearing
poor fitting shoes, or shoes that do not provide enough support or cushioning. Not stretching properly or at all before and after exercise. Those who are on their feet for long periods of time.
Usually worse with the first few steps in the morning or at the initial point of activity. The latter usually gets better with continued activity (squeaky hinge analogy). Walking, running, sprinting,
hill running and jumping will increase the pain. Often, the natural response is to walk on the outside of the foot - in supination - to lessen the stress on the plantar fascia - resulting in new
A biomechanical exam by your podiatrist will help reveal these abnormalities and in turn resolve the cause of plantar fasciitis. By addressing this cause, the patient can be offered a podiatric
long-term solution to his problem.
Non Surgical Treatment
Calf stretch, Heel cups/lifts, ice, night splint, physical therapy, activity modification. Sometimes immobilization in a cast or boot may be necessary. Topical creams, such as Voltaren or Ketoprofen,
have been found to have some benefit. In some cases, the tendon may become degenerative (tendonosis). In these instances, treatment is more difficult. Prolonged periods of immobilization and physical
therapy may be required. In resistant cases, surgical debridement of the tendon may be necessary. Rarely does a symptomatic achilles tendon rupture. Most achilles ruptures are not associated with
prodromal symptoms. Achilles ruptures are more common in men and "weekend warriors," ie middle aged men who like to play sports (soccer, softball, basketball) on the weekends.
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.
Wear properly fitting shoes. Place insoles or inserts in your shoes to help control abnormal foot motion. Maintain a healthy weight. Exercise and do foot stretches as they have been shown to decrease
the incidence of heel pain.