Heel pain is a very common foot complaint and may involve injury to the bone, fat pad, ligaments, tendons or muscles. Heel Pain
can also be referred by a pinched nerve in your lower back. It is important to have your heel pain
thoroughly assessed to ensure an accurate diagnosis and subsequent treatment. Anyone can suffer from heel pain, but certain groups seem to be at increased risk, including middle aged men and women,
active people eg running sports, people who are very overweight, children aged between 8 and 13 years, pregnant women, people who stand for long periods of time.
Near the inflamed plantar fascia attachment, but not in it, some extra bone may form, producing a small "spur". In fact, it is a shelf of bone, not a sharp spur. These "heel spurs" are commoner in
people with plantar fascitis, but they can be found in people with no heel pain. The heel spur is caused by the same process as the heel pain, but the spur is not itself the cause of the pain.
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.
The diagnosis of plantar fasciitis is generally made during the history and physical examination. There are several conditions that can cause heel pain, and plantar fasciitis must be distinguished
from these conditions. Pain can be referred to the heel and foot from other areas of the body such as the low back, hip, knee, and/or ankle. Special tests to challenge these areas are performed to
help confirm the problem is truly coming from the plantar fascia. An X-ray may be ordered to rule out a stress fracture of the heel bone and to see if a bone spur is present that is large enough to
cause problems. Other helpful imaging studies include bone scans, MRI, and ultrasound. Ultrasonographic exam may be favored as it is quick, less expensive, and does not expose you to radiation.
Laboratory investigation may be necessary in some cases to rule out a systemic illness causing the heel pain, such as rheumatoid arthritis, Reiter's syndrome, or ankylosing spondylitis. These are
diseases that affect the entire body but may show up at first as pain in the heel.
Non Surgical Treatment
Anti-inflammatory medication. Heel stretching exercise. Ice application to painful area - twice a day or more, for 10 - 15 minutes. Rest. Supportive, well-fitting, padded shoes. Heel cup, felt pads
or orthotics. Night splints - stretches injured fascia and allows healing. Basic treatment. First thing in the morning, before getting out of bed -- massage the bottom of the affected foot or feet
for at least five minutes. Ensure that the plantar is stretched and warmed up so that overnight healing remains intact. Before stepping out of bed, be sure that you have soft, padded, supportive
shoes or slippers to wear, especially if your flooring is hard, tile or uncarpeted flooring.
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).
Prevention of heel pain involves reducing the stress on that part of the body. Tips include. Barefeet, when on hard ground make sure you are wearing shoes. Bodyweight, if you are overweight there is
more stress on the heels when you walk or run. Try to lose weight. Footwear, footwear that has material which can absorb some of the stress placed on the heel may help protect it. Examples include
heel pads. Make sure your shoes fit properly and do not have worn down heels or soles. If you notice a link between a particular pair of shoes and heel pain, stop wearing them. Rest, if you are
especially susceptible to heel pain, try to spend more time resting and less time on your feet. It is best to discuss this point with a specialized health care professional. Sports, warm up properly
before engaging in activities that may place lots of stress on the heels. Make sure you have proper sports shoes for your task.