Heel pain can stem from several different etiologies. The most common cause of chronic heel pain is a condition known as plantar fasciitis. Plantar fasciitis is an ailment in which inflammation occurs at the connection point of a thick fibrous band at the bottom of your foot, known as your plantar fascia, which attaches at your heel bone (calcaneus) all the way to your metatarsals. This fascial band supports the bottom of your foot and establishes a framework for your arch.
When the plantar fascial band is too tight it can cause pain, swelling, inflammation and discomfort at the bottom of your heel. One of the most common symptoms is pain when first stepping out of bed or even sharp, stabbing pain at the heel when transitioning from a sitting to a standing position. If this sounds familiar… keep reading!
Most often patients may experience this initial discomfort, however, once they start moving the pain will often reduce or subside completely. This is because the plantar fascial band is stretching and “warming up” as you begin to move more. What are some things that can be done? Well, glad you asked.
There are several conservative or non-surgical treatment options that can be available for patients that are often easy and effective. First and foremost, stretching exercises are crucial in a patient’s recovery. Through either formal physical therapy or a home exercise program, patients can learn how to properly stretch their plantar fascial band before they start their day and in turn decreasing the amount of tension on the heel. Another modality that can be helpful in stretching is using a night splint. A night splint is a small device that you wear throughout the night that helps stretch your calf and plantar fascial band. This device is known to be helpful for some patients. Lastly, custom-molded orthotics may help to support your arch and foot and decrease the pull of the plantar fascia while walking, standing and being active.
In addition to stretching, plantar fasciitis can be addressed with medicinal modalities, as well. Either prescribed or over the counter non-steroidal anti-inflammatories (NSAIDs) can often be beneficial. In severe cases, a short course of a low dose oral steroid may help. Furthermore, a series of corticosteroid injections may also be warranted. This injection is administered at the heel right in the office. Essentially, all treatments attempt to attack the inflammation at the heel resulting in alleviation of symptoms.
Other options include but are not limited to shockwave therapy, EPAT and surgery.
If you’re experiencing heel pain that just won’t go away, come see us at Complete Foot and Ankle and we’ll be happy to help heal your heel pain!