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.
Heel pain is most often the result of overuse. Rarely, it may be caused by an injury. Your heel may become tender or swollen from, shoes with poor support or shock absorption. Running on hard
surfaces, like concrete. Running too often. Tightness in your calf muscle or the Achilles tendon. Sudden inward or outward turning of your heel. Landing hard or awkwardly on the heel. Conditions that
may cause heel pain include. When the tendon that connects the back of your leg to your heel becomes swollen and painful near the bottom of the foot. Swelling of the fluid-filled sac (bursa) at the
back of the heel bone under the Achilles tendon (bursitis). Bone spurs in the heel. Swelling of the thick band of tissue on the bottom of your foot (plantar fasciitis). Fracture of the heel bone that
is related to landing very hard on your heel from a fall (calcaneus fracture).
The symptoms of plantar fasciitis include pain along the inside edge of the heel near the arch of the foot. The pain is worse when weight is placed on the foot especially after a long period of rest
or inactivity. This is usually most pronounced in the morning when the foot is first placed on the floor. This symptom called first-step pain is typical of plantar fasciitis. Prolonged standing can
also increase the painful symptoms. It may feel better after activity but most patients report increased pain by the end of the day. Pressing on this part of the heel causes tenderness. Pulling the
toes back toward the face can be very painful.
In most cases, your GP or a podiatrist (a specialist in foot problems and foot care) should be able to diagnose the cause of your heel pain by asking about your symptoms and medical history,
examining your heel and foot.
Non Surgical Treatment
Using our state-of-the-art equipment, Dr. Weinert is able to provide a full work up for the heel, including gait analysis. Digital imagining gives him and the patient a full view of the foot and
injury to help formulate the best treatment plan possible. There are numerous treatment options available to help with heel pain and plantar fasciitis. Anti-inflammatory medications. Digital custom
orthotics. Physical therapy. Diagnostic and ultrasonic guided injection therapy. No one should ever resign to living with foot pain.
Surgery is a last resort in the treatment of heel pain. Physicians have developed many procedures in the last 100 years to try to cure heel pain. Most procedures that are commonly used today focus on
several areas, remove the bone spur (if one is present), release the plantar fascia (plantar fasciotomy), release pressure on the small nerves in the area. Usually the procedure is done through a
small incision on the inside edge of the foot, although some surgeons now perform this type of surgery using an endoscope. An endoscope is a tiny TV camera that can be inserted into a joint or under
the skin to allow the surgeon to see the structures involved in the surgery. By using the endoscope, a surgeon can complete the surgery with a smaller incision and presumably less damage to normal
tissues. It is unclear whether an endoscopic procedure for this condition is better than the traditional small incision. Surgery usually involves identifying the area where the plantar fascia
attaches to the heel and releasing the fascia partially from the bone. If a small spur is present this is removed. The small nerves that travel under the plantar fascia are identified and released
from anything that seems to be causing pressure on the nerves. This surgery can usually be done on an outpatient basis. This means you can leave the hospital the same day.
Maintaining flexible and strong muscles in your calves, ankles, and feet can help prevent some types of heel pain. Always stretch and warm-up before exercising. Wear comfortable, properly fitting
shoes with good arch support and cushioning. Make sure there is enough room for your toes.