Heel pain is one of the most common conditions to affect the foot. It is usually felt as an intense pain when the affected heel is used. The pain is usually worse when you get out of bed in the
morning or after a long period of activity. In most cases, only one heel is affected. After walking, the pain usually improves. However, it is common for it to be painful when you first take a step
after a period of rest. The pain often worsens by the end of the day. Most cases of Heel Pain
are caused by damage and thickening of the plantar fascia. Sometimes, the
surrounding tissue and the heel bone also become inflamed (swollen).
A flattening or overstretching of your plantar fascia can cause microscopic tears, inflammation, and a burning sensation. While developing slowly, there may be a sudden severe event sometimes
occurring in only one foot at a time. Plantar Faciitis can affect people of all ages and backgrounds. Some contributing factors include age, weight-bearing activities, sudden increase in physical
activity, improper shoes, excess weight or a recent weight gain (as little as 5 pounds), and poor biomechanics (flat feet, high arches or unnatural gait).
See your doctor as soon as possible if you experience severe pain accompanied by swelling near your heel. There is numbness or tingling in the heel, as well as pain and fever. There is pain in your
heel as well as fever. You are unable to walk normally. You cannot bend your foot downwards. You cannot stand with the backs of the feet raised (you cannot rise onto your toes). You should arrange to
see a doctor if the heel pain has persisted for more than one week. There is still heel pain when you are not standing or walking.
Depending on the condition, the cause of heel pain is diagnosed using a number of tests, including medical history, physical examination, including examination of joints and muscles of the foot and
Non Surgical Treatment
Essentially rest from aggravating activity, physiotherapy treatment to alleviate the inflammatory component, stretching the tight calf, strengthening up of the intrinsic muscles of the foot e.g.
tissue scrunch, picking up pens etc. and correction of biomechanical problems in the foot e.g. orthotics. Sometimes, a heel cup or pad to relieve pressure - a donut type pad may be helpful. Strapping
has been shown to be helpful, especially in circumstances where the patient can?t wear orthotics - the foot is strapped to help support the arch. There has been limited success with cortisone
injections or surgery and the latter is very rarely required.
Extracorporeal shockwave therapy (EST) is a fairly new type of non-invasive treatment. Non-invasive means it does not involve making cuts into your body. EST involves using a device to deliver
high-energy soundwaves into your heel. The soundwaves can sometimes cause pain, so a local anaesthetic may be used to numb your heel. It is claimed that EST works in two ways. It is thought to have a
"numbing" effect on the nerves that transmit pain signals to your brain, help stimulate and speed up the healing process. However, these claims have not yet been definitively proven. The National
Institute for Health and Care Excellence (NICE) has issued guidance about the use of EST for treating plantar fasciitis. NICE states there are no concerns over the safety of EST, but there are
uncertainties about how effective the procedure is for treating heel pain. Some studies have reported that EST is more effective than surgery and other non-surgical treatments, while other studies
found the procedure to be no better than a placebo (sham treatment).
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.