H HEEL PAIN

HEEL PAIN
H
eel pain is most often caused
spending long periods of time on
by plantar fasciitis—a condition
their feet.
In addition, diagnostic imaging
studies such as x-rays, a bone scan, or
that is sometimes also called heel spur
magnetic resonance imaging (MRI)
syndrome when a spur is present.
may be used to distinguish the differ-
Heel pain may also be due to other
ent types of heel pain. Sometimes
causes, such as a stress fracture,
heel spurs are found in patients with
tendonitis, arthritis, nerve irritation,
plantar fasciitis, but these are rarely a
or, rarely, a cyst.
source of pain. When they are present,
Because there are several potential
the condition may be diagnosed as
causes, it is important to have heel
plantar fasciitis/heel spur syndrome.
pain properly diagnosed. A podiatric
Treatment Options
foot and ankle surgeon is best
trained to distinguish between all
Causes of Plantar Fasciitis
Treatment of plantar fasciitis begins
the possibilities and determine the
The most common cause of plantar
with first-line strategies, which you
underlying source of your heel pain.
fasciitis relates to faulty structure of
can begin at home:
the foot. For example, people who
• Stretching exercises. Exercises that
What Is Plantar Fasciitis?
have problems with their arches—
stretch out the calf muscles help
Plantar fasciitis is an inflammation
either overly flat feet or high-arched
ease pain and assist with recovery.
of the band of tissue (the plantar
feet—are more prone to developing
fascia) that extends from the heel to
plantar fasciitis.
the toes. In this condition, the fascia
Wearing non-supportive footwear
• Avoid going barefoot. When you
walk without shoes, you put
undue strain and stress on your
first becomes irritated and then
on hard, flat surfaces puts abnormal
inflamed—resulting in heel pain.
strain on the plantar fascia and
The symptoms of plantar fasciitis are:
can also lead to plantar fasciitis.
heel for 10 minutes several times
• Pain on the bottom of the heel
This is particularly evident when a
a day helps reduce inflammation.
• Pain that is usually worse upon
person’s job requires long hours on
arising
• Pain that increases over a period
plantar fascia.
• Ice. Putting an ice pack on your
• Limit activities. Cut down on
their feet. Obesity also contributes
extended physical activities to
to plantar fasciitis.
give your heel a rest.
of months
• Shoe modifications. Wearing
People with plantar fasciitis often
Diagnosis
describe the pain as worse when
To arrive at a diagnosis, the podiatric
arch support and a slightly raised
they get up in the morning or after
foot and ankle surgeon will obtain
heel reduces stress on the plantar
they’ve been sitting for long periods of
your medical history and examine
fascia. Your shoes should provide
time. After a few minutes of walking
your foot. Throughout this process
a comfortable environment for
the pain decreases, because walking
the surgeon rules out all the possible
the foot.
stretches the fascia. For some people
causes for your heel pain other than
the pain subsides but returns after
plantar fasciitis.
supportive shoes that have good
• Medications. Nonsteroidal antiinflammatory drugs (NSAIDs),
such as ibuprofen, may help
to help reduce the inflammation
after several months of non-surgical
reduce pain and inflammation.
and relieve pain.
treatment, you continue to have heel
• Lose weight. Extra pounds put
extra stress on your plantar fascia.
• Removable walking cast. A
pain, surgery will be considered. Your
removable walking cast may be
podiatric foot and ankle surgeon will
used to keep your foot immobile
discuss the surgical options with you
If you still have pain after several
for a few weeks to allow it to rest
and determine which approach
weeks, see your podiatric surgeon,
and heal.
would be most beneficial for you.
who may add one or more of these
• Night splint. Wearing a night
approaches:
splint allows you to maintain
Long-term Care
• Padding and strapping. Placing
an extended stretch of the plantar
No matter what kind of treatment
pads in the shoe softens the
fascia while sleeping. This may
you undergo for plantar fasciitis, the
impact of walking. Strapping
help reduce the morning pain
underlying causes that led to this
helps support the foot and reduce
experienced by some patients.
condition may remain. Therefore, you
strain on the fascia.
• Orthotic devices. Custom orthotic
devices that fit into your shoe
• Physical therapy. Exercises and
will need to continue with preventive
other physical therapy measures
measures. If you are overweight, it is
may be used to help provide relief.
important to reach and maintain an
ideal weight. For all patients, wearing
help correct the underlying
structural abnormalities causing
Although most patients with plantar
supportive shoes and using custom
the plantar fasciitis.
fasciitis respond to non-surgical
orthotic devices are the mainstay
• Injection therapy. In some cases,
treatment, a small percentage of
of long-term treatment for plantar
corticosteroid injections are used
patients may require surgery. If,
fasciitis. ▲
This information has been prepared by the Consumer Education Committee of the American College of Foot and Ankle
Surgeons, a professional society of 5,700 podiatric foot and ankle surgeons. Members of the College are Doctors of
Podiatric Medicine who have received additional training through surgical residency programs.
The mission of the College is to promote superior care of foot and ankle surgical patients through education,
research and the promotion of the highest professional standards.
Copyright © 2004, American College of Foot and Ankle Surgeons • www.acfas.org