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Heel Pain

feet walking through grass

31 May Heel Pain

Heel pain is one of the most common types of foot pain. Children can develop pain due to inflammation of the heel growth plate (see Children’s Foot Problems). Those in all age groups can fracture (break) their heel bone due to trauma or overuse. Nerve entrapment, tumors, and arthritis can cause heel pain as well. In most cases, heel pain is caused by a condition called plantar fasciitis. Plantar fasciitis is an inflammation of an important ligament called the plantar fascia which runs from the heel along the entire bottom of the foot.

Often plantar fasciitis is caused by mechanical instability of the arch of the foot (too high or too flat of an arch). In other words, without control of the movement of the arch, the plantar fascia ligament gets pulled excessively leading to pain. The pain often initially is present when first standing up after sleeping or sitting, but can progress to the point of hurting all the time. Other factors such as weight gain, barefoot walking, trauma, overtraining for sports, poor shoe gear, and even standing on hard surfaces can contribute to the pain.

The doctors of Alta Ridge Foot Specialists will examine your foot, check your gait and shoes, and utilize x-rays to evaluate your condition. In some instances, other diagnostic tests such as a bone scan or magnetic resonance imaging (MRI) may be used to distinguish the different types of heel pain.

Fortunately, many cases of plantar fasciitis resolve with first-line treatments which usually include:

  • Custom orthotics – which control the mechanical instability of the foot, reducing pain much like eyeglasses control the mechanical imbalance of the eye, allowing one to see.
  • Stretching exercises
  • Night splint – this stretches the plantar fascia and speeds recovery by 80%.
  • Anti-inflammatory medicines
  • Cortisone injections
  • Ice
  • Using supportive shoes and avoiding barefoot walking and standing

In some more chronic cases cast immobilization, extracorporeal shockwave therapy (see EPAT for more details), and surgery may be necessary. Even after initial treatment, long term use of the orthotics and stretching help manage the problem and help reduce recurrence of the problem.