If you are experiencing pain in the heel and around the arch of your foot, you may have plantar fasciitis.
This common cause of heel pain is due to inflammation of the plantar fascia, a tough band of tissue that runs from the heel bone to the base of the toes, acting a shock-absorber as you walk and helping to support the arch of the foot.
Causes of plantar fasciitis
If the fascia is subjected to repeated tension and stress, it can become irritated and develop small tears. Although the precise cause of plantar fasciitis is unclear, it is believed that repeated stretching and tearing of this band of tissue is a key factor. Long-distance runners, ballet dancers and aerobics instructors are especially susceptible, along with anyone who participates in activities that place the heel and foot under repeated strain.
If your job involves long hours of standing or walking on hard surfaces – for example factory workers, teachers or nurses – you may develop plantar fasciitis. Being overweight is a risk factor, as is having flat feet or a high foot arch. The way you walk can also place you at risk of developing plantar fasciitis as it impacts on the distribution of your weight which can strain the tissues.
Symptoms of plantar fasciitis
The condition causes a stabbing sensation at the base of your foot near the heel. The pain is normally worse first thing in the morning when you take your first few steps or when you stand up after a period of sitting. It can be particularly bad when you stand for an extended time. Although plantar fasciitis by itself is not a serious condition, experiencing chronic heel pain may alter the way you walk and this can lead to back, hip or knee problems. Having heel pain can also hinder day-to-day activities like walking or taking part in sport and this can have a big impact on your quality of life.
Diagnosing plantar fasciitis
Your doctor will carry out a physical examination of your foot and check for areas of tenderness. If they suspect you may have a stress fracture, they may recommend an X-ray or MRI scan to rule this out.
Treating plantar fasciitis
In most cases, plantar fasciitis will get better by itself over a period of months. We recommend taking anti-inflammatories and painkillers in the meantime to relieve the symptoms. You can try an ice pack to reduce inflammation and you may need to use orthotics, which are custom-fitted arch supports that you wear in your shoes to distribute the pressure on your feet more evenly.
A physiotherapist can recommend exercises to stretch the plantar fascia and Achilles tendon and build strength in the muscles of the lower leg.
You may need to wear night splints which hold the Achilles tendon and plantar fascia in a lengthened position to help stretch it out as you sleep.
In some cases, however, if the condition does not improve after a few months you may need surgery or other types of treatment.
At York Orthopaedics we offer steroid injections into the affected area to help relieve pain and inflammation in the short-term.
Extracorporeal shock wave therapy uses sound waves directed at the heel to stimulate the body’s own healing response. Platelet rich plasma injections work in a similar way but using an injection of blood taken from your own body and treated to separate out the different components. In rare cases you may need surgery. Your doctor will normally only recommend surgery if the pain is severe and other treatments have failed. During surgery, which can be performed arthroscopically using a small incision, the plantar fascia is detached from the heel bone to relieve pain.
Other causes of heel pain
While plantar fasciitis is the most common cause of heel pain, there are several other possible causes, which is why it is important to seek a professional diagnosis.
For example, you may have Achilles tendonitis or tendon rupture. Heel pain can also be due to bursitis, stress fracture, rheumatoid arthritis or osteomyelitis.
For more information about heel pain, including plantar fasciitis, and for information about diagnosis and treatment options, contact us.
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