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Heel Pain And Discomfort

Overview

Heel Discomfort

Plantar heel pain is a commonly encountered orthopedic problem that can cause significant discomfort and a limp because of the difficulty in bearing weight. The etiologies of this condition are multiple; therefore, a careful clinical evaluation is necessary for its appropriate management. Nonsurgical or conservative care is successful in most cases.

Causes

he most common cause of heel pain is over pronation, this is when your foot rotates in too much as you walk. You really need to treat the underlying cause of the heel pain as soon as possible to prevent any further damage to the plantar fascia. Excessive load on the foot from obesity is a major cause of plantar fasciitis. Which is why this condition is common in middle aged and over weight adults. A sudden increase in weight, such as pregnancy can also lead to plantar fascitis. A sudden increase in walking or a sporting activity can also be a contributing factor. A classic example of when this condition can develop is when a post man has returned to work after a period away from the job. Tight plantar fascia (this is often caused by tight calf muscles). Excessive flattening of the arch on weight bearing i.e. flat feet. People with flat feet are more at risk of developing this condition. Biomechanical problems (walking abnormalities) is a major cause of plantar fasciitis. Different types of arthritis can also lead to this condition, such as osteoarthritis and rheumatoid arthritis.

Symptoms

Pain in the bottom of the heel is the most common symptom. The pain is often described as a knife-like, pinpoint pain that is worse in the morning and generally improves throughout the day. By the end of the day the pain may be replaced by a dull ache that improves with rest. The pain results from stretching the damaged tissues. For the same reason atheletes' pain occurs during beginning stages of exercise and is relieved over time as warm-up loosens the fascia. Plantar fasciitis onset is usually gradual, only flaring up during exercise. If pain is ignored, it can eventually interfere with walking and overall, plantar fasciitis accounts for about ten percent of all running injuries.

Diagnosis

To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.

Non Surgical Treatment

Treatments to add to your stretching program include wearing good-quality shoes, icing the painful area, and massaging the arch. Do not walk barefoot; walk in shoes with good heel and arch supports such as high-quality walking or running shoes. Keep a pair of shoes next to your bed so you can put them on before taking your first step. Your doctor may recommend that you wear an additional arch support or a heel cup in the shoes. Icing your foot can help relieve pain. Rub a frozen bottle of water or an ice cup over the tender areas for five minutes two times each day. Massage your foot by rolling a tennis, golf ball, or baseball along your sole and heel. This friction massage can help break up adhesions and stretch the plantar fascia. Do this for five minutes two times each day. If you are a runner or just started a walking or running program, evaluate your training for errors such as warming up improperly, increasing mileage too quickly, running hills excessively, running on surfaces that are too hard, or wearing broken down shoes. Adjusting your training program can help relieve your pain. While recovering from heel pain, walk or jog in a pool or crosstrain by biking and swimming. These activities maintain your cardiovascular fitness without stressing your heel cord or plantar fascia. Heel pain takes time to go away. Be patient and remember that no treatment is a substitute for STRETCHING!

Surgical Treatment

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).

heel pain treatment

Prevention

Heel Pain

Flexibility is key when it comes to staving off the pain associated with these heel conditions. The body is designed to work in harmony, so stretching shouldn?t be concentrated solely on the foot itself. The sympathetic tendons and muscles that move the foot should also be stretched and gently exercised to ensure the best results for your heel stretches. Take the time to stretch thighs, calves and ankles to encourage healthy blood flow and relaxed muscle tension that will keep pain to a minimum. If ice is recommended by a doctor, try freezing a half bottle of water and slowly rolling your bare foot back and forth over it for as long as is comfortable. The use of elastic or canvas straps to facilitate stretching of an extended leg can also be helpful when stretching without an assistant handy. Once cleared by a doctor, a daily regimen of over-the-counter anti-inflammatory medication like Naproxen Sodium will keep pain at bay and increase flexibility in those afflicted by heel pain. While this medication is not intended to act as a substitute for medical assessments, orthopedics or stretching, it can nonetheless be helpful in keeping discomfort muted enough to enjoy daily life. When taking any medication for your heel pain, be sure to follow directions regarding food and drink, and ask your pharmacist about possible interactions with existing medications or frequent activities.