Typical heel pain often presents itself as a sharp, achy discomfort under the heel. It can often feel like a bruised heel and can get progressively worse. Pain often is worse with the first couple of steps in the morning or after rest.

Most often heel pain is caused by an inflammation of the plantar fascia a broad ligament connecting the heel to the ball of the foot.  This inflammation is called plantar fasciitis.

A bone spur under the heel may also present however, it typically is not the cause of the pain.

Other causes of heel pain may be stress fractures, sports injury, tendonitis, arthritis, nerve irritation, or a bone cyst.

Causes of Heel Pain

Heel pain occurs most frequently as a foot flattens or pronates when you walk. This places an added strain on the plantar fascia.  As this ligament undergoes stress and strain, it becomes inflamed and causes pain. Strain is also placed upon the soft tissue within the arch, including the muscles and ligaments that attach to the heel. When left untreated, pain and spurring ensues.

Contributing factors may include weight, genetics, choosing the wrong shoes, and lifestyle such as working on cement floors.

Heel bursitis can develop in those feet with an excessively high arch.

Diagnostic Tests. Physical examination including X-ray and Diagnostic Ultrasound. These tests help enable the doctor to diagnose the cause and measure the exact amount of inflammation present in the heel, as well as track the healing process.

Treatment

Treatment options are unique for each patient. We look forward to discussing your personal treatment plan with you based on your needs.

Non-surgical Approach

Recommend home treatments include:

• Stretching the calf muscle to help ease pain and assist with recovery.
• Not walking barefoot to minimize strain and stress on the plantar fascia.
• Using an ice pack on your heel for 10 minutes several times a day.
• Rest
• Wearing supportive shoes that have a slightly raised heel reduces stress on the plantar fascia.
• Losing weight.  Extra pounds put extra stress on your plantar fascia.

Our in office treatment includes:

• Kinesio elastic taping to reduce strain on the plantar fascia
• Orthotic devices. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis and usually will prevent reoccurrence of heel pain.
• Injection therapy. Corticosteroid injections are used to help reduce the inflammation and relieve pain.

SURGICAL APPROACH:

Surgical treatment is not considered unless heel pain is unrelenting and all conservative treatments have been used for a minimum of three to six months. Surgical treatment usually consists of releasing the painful side of the strained plantar fascia thus alleviating stress from the heel. Severe cases may also require the cutting and removal of the heel spur itself.

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