The most common cause of Heel Pain
is inflammation due to injury of the soft tissue around your heel. The
plantar fascia is the area of your foot most likely to be inflamed, which results in plantar fasciitis. With plantar fasciitis, you experience a sharp burning or stabbing sensation upon arising after
walking or standing for prolonged periods. Your first steps each morning probably hurt, too. Heel pain is occasionally caused by excessive pounding on the heels. This is more common in the elderly
and overweight individuals whose heel fat pads no longer function properly. Watch for a bruising sensation under the heel when standing and walking. If you think this is your issue, an insert with an
artificial fat pad might help alleviate your discomfort. Heel pain is by far the most common foot complaint. There are many medical conditions that are associated with heel pain, including gout and
other forms of arthritis.
In the majority of cases, heel pain has a mechanical cause. It may also be caused by arthritis, infection, an autoimmune problem trauma, a neurological problem, or some other systemic condition
(condition that affects the whole body).
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
Your GP or podiatrist (a healthcare professional who specialises in foot care) may be able to diagnose the cause of your heel pain by asking about your symptoms and examining your heel and foot. You
will usually only need further tests if you have additional symptoms that suggest the cause of your heel pain is not inflammation, such as numbness or a tingling sensation in your foot - this could
be a sign of nerve damage in your feet and legs (peripheral neuropathy), your foot feels hot and you have a high temperature (fever) of 38C (100.4F) or above - these could be signs of a bone
infection, you have stiffness and swelling in your heel - this could be a sign of arthritis. Possible further tests may include, blood tests, X-rays - where small doses of radiation are used to
detect problems with your bones and tissues, a magnetic resonance imaging (MRI) scan or ultrasound scan, which are more detailed scans.
Non Surgical Treatment
If pain and other symptoms of inflammation-redness, swelling, heat-persist, you should limit normal daily activities and contact our office, or another doctor of podiatric medicine. Your foot would
be examined, and an X-ray may be taken to rule out problems of the bone. Early treatment might involve oral or injectable anti-inflammatory medication, taping, padding, massage, stretching, exercise,
shoe recommendations, physiotherapy, over-the-counter shoe inserts or, if the condition is chronic and there is a biomechanical basis to the complaint, orthoses (or orthotic devices) may be used to
permanently take strain off the fascia. Only rarely is surgery required for heel pain. If necessary, however, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa,
or removal of a neuroma or other soft-tissue growth.
When a diagnosis of plantar fasciitis is made early, most patients respond to conservative treatment and don?t require surgical intervention. Often, when there is a secondary diagnosis contributing
to your pain, such as an entrapped nerve, and you are non-responsive to conservative care, surgery may be considered. Dr. Talarico will discuss all options and which approach would be the most
beneficial for your condition.
You can reduce the risk of heel pain in many ways, including. Wear shoes that fit you properly with a firm fastening, such as laces. Choose shoes with shock-absorbent soles and supportive heels.
Repair or throw out any shoes that have worn heels. Always warm up and cool down when exercising or playing sport, include plenty of slow, sustained stretches. If necessary, your podiatrist will show
you how to tape or strap your feet to help support the muscles and ligaments. Shoe inserts (orthoses) professionally fitted by your podiatrist can help support your feet in the long term.