What Is Painful Heel

Published on

Plantar Fascitis

Overview

Plantar fasciitis is that pain in the bottom of your foot usually felt around your heel. That pain is especially strong with the first few steps in the morning as you are getting out of bed and standing on your feet, or after sitting and resting for awhile. The name Plantar fasciitis comes from: "Plantar" which means something that belongs to the foot, "fascia" which is a band or ligament or a connective tissue, and "itis" which means inflammation. The band connects the heel bone to the bones of the toes. The pain is caused by injuring this tough band on the bottom of the foot.




Causes

A number of factors can contribute to plantar fasciitis. While men can get plantar fasciitis, it is more common in women. You're also more likely to have this condition as you age or if you are overweight. Take up a new form of exercise or suddenly increase the intensity of your exercise. Are on your feet for several hours each day. Have other medical conditions such as rheumatoid arthritis or lupus (systemic lupus erythematosus). Tend to wear high-heeled shoes, and then switch abruptly to flat shoes. Wear shoes that are worn out with weak arch supports and thin soles. Have flat feet or an unusually high arch. Have legs of uneven lengths or an abnormal walk or foot position. Have tight achilles tendons, or ‘heel cords’.




Symptoms

You'll typically first notice early plantar fasciitis pain under your heel or in your foot arch in the morning or after resting. Your heel pain will be worse with the first steps and improves with activity as it warms up. As plantar fasciitis deteriorates, the pain will be present more often. You can determine what stage your are in using the following guidelines. No Heel Pain, Normal! Heel pain after exercise. Heel pain before and after exercise. Heel pain before, during and after exercise. Heel pain all the time. Including at rest! This symptom progression is consistent with the four stages of a typical overuse injury. Ultimately, further trauma and delayed healing will result in the formation of calcium (bone) within the plantar fascia. When this occurs adjacent to the heel bone it is known as heel spurs, which have a longer rehabilitation period.




Diagnosis

Your doctor can usually diagnose plantar fasciitis just by talking to you and examining your feet. Rarely, tests are needed if the diagnosis is uncertain or to rule out other possible causes of heel pain. These can include X-rays of the heel or an ultrasound scan of the fascia. An ultrasound scan usually shows thickening and swelling of the fascia in plantar fasciitis.




Non Surgical Treatment

In the early stages of plantar fasciitis resting the foot may ease the pain. Medication to reduce inflammation should help but should only be used short term. Strapping may temporarily reduce the pain. All of the above therapies are only temporary measures and the pain is likely to reoccur if the cause of the abnormal pressure which has triggered the plantar fasciitis has not been identified. In order to establish the cause of the plantar fasciitis a biomechanical assessment may be required.

Plantar Fascia




Surgical Treatment

If you consider surgery, your original diagnosis should be confirmed by the surgeon first. In addition, supporting diagnostic evidence (such as nerve-conduction studies) should be gathered to rule out nerve entrapment, particularly of the first branch of the lateral plantar nerve and the medial plantar nerve. Blood tests should consist of an erythrocyte sedimentation rate (ESR), rheumatoid factor, human leukocyte antigen B27 (HLA-B27), and uric acid. It’s important to understand that surgical treatment of bone spurs rarely improves plantar fasciitis pain. And surgery for plantar fasciitis can cause secondary complications-a troubling condition known as lateral column syndrome.

Comment on this post