Heel pain is unlike most body aches and injuries because heels can't be immobilized to rest and recover, at least without considerable inconvenience to the sufferer. Heels can?t be isolated and
splinted either ,as body weight will continue to aggravate the condition with every step. Heel pain can be devastating if left untreated, eventually impairing the ability to walk comfortably-or at
all. Most Heel Pain
comes from tendon problems,
though some types can come from bone issues as well.
Long standing inflammation causes the deposition of calcium at the point where the plantar fascia inserts into the heel. This results in the appearance of a sharp thorn like heel spur on x-ray. The
heel spur is asymptomatic (not painful), the pain arises from the inflammation of the plantar fascia.
The symptoms of plantar fasciitis are pain on the bottom of the heel, pain in the arch of the foot, pain that is usually worse upon arising, pain that increases over a period of months. People with
plantar fasciitis often describe the pain as worse when they get up in the morning or after they?ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because
walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.
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
Treatment includes resting from the activities that caused the problem, doing certain stretching exercises, using pain medication and wearing open-back shoes. Your doctor may want you to use a 3/8"
or 1/2" heel insert. Stretch your Achilles tendon by leaning forward against a wall with your foot flat on the floor and heel elevated with the insert. Use nonsteroidal anti-inflammatory medications
for pain and swelling. Consider placing ice on the back of the heel to reduce inflammation.
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).
A variety of steps can be taken to avoid heel pain and accompanying afflictions. Wear shoes that fit well-front, back, and sides-and have shock-absorbent soles, rigid shanks, and supportive heel
counters. Wear the proper shoes for each activity. Do not wear shoes with excessive wear on heels or soles. Prepare properly before exercising. Warm up and do stretching exercises before and after
running. Pace yourself when you participate in athletic activities. Don?t underestimate your body's need for rest and good nutrition. If obese, lose weight.