Heel Pain

Heel pain is by far the most common foot complaint in the UK with many thousands of people suffering.

  

.........."a sharp, stabbing pain in the heel usually experienced when you first get up in the morning or after periods of inactivity"</p>

What exactly causes heel pain?

The most common cause of heel pain and heel spurs is Plantar Fasciitis.  The plantar fascia is the band of fibrous tissue which connects the heel bone to the toe bones. Its function is to support the arch of your foot. A normal fascia tendon is strong and flexible but abnormal stress, excessive weight, age and poor foot function can cause micro-tears which will lead to irritation and inflammation at the attachment of the plantar fascia into the calcaneus (heel bone).

During rest (e.g. when you're asleep), the plantar fascia tightens and shortens. When body weight is rapidly applied to the foot, the fascia must stretch and quickly lengthen, causing micro-tears in the fascia. Hence, the stabbing pain with your first steps in the morning. After a little bit of walking the stabbing pain usually subsides.

 

 

 Heel pain or Plantar Fasciitis is common in the following circumstances:

  • you suffer from over-pronation (lowering of the arches)
  • you are over 50 years of age
  • you are overweight or pregnant
  • you stand or walk on hard surfaces for long periods
  • you do a lot of running and/or sports
  • you have tight calf muscles

Other less common causes of heel pain may include:

Burstitis - This is the inflammation of the small, fluid filled sacs (Bursa) which are found between tendons and bones.

Fat Pad Atrophy - This is where the fat pad under the heel is damaged due to too much strain.  Women who wear high heels a lot are more prone to this.

Sever's Disease - This is more common in children.  It is caused by the tightening and lengthening of muscles and tendons due to growth spurts.

Tarsal Tunnel Syndrome - There is a small "tunnel" by the ankle joint which the nerves for the foot pass through.  If this is damaged then the nerves are compressed and this can result in pain along the foot including under the heel.

Treatment

Treatment

1) Medical interventions

Cortisone-steroid injections

Cortisone-steroids are a strong anti-inflammatory. They are injected directly into the heel bone and will work almost immediately. The injection itself can be very painful and in many patients more injections are needed as pain relief usually only lasts up to 6 weeks. This type of treatment does not address the biomechanical cause of the problem.

Shock-wave treatment

Shockwave therapy is very common in the USA. The specialist targets therapeutic shockwaves to the affected heel area.The treatment needs to be repeated for 3 to 4 months to be fully effective. The shockwaves stimulate a healing response in the inflamed plantar fascia tissue.

Surgery

Surgery is seldom required and only in cases whereby everything else has failed. The surgeon makes an incision into the ligament, partially cutting the plantar fascia to release the excess tension. If bone spur is present, it will be removed.

2) Self-Treatment solutions

Before seeking help from a doctor or specialist, you may want to consider some self-treatment options. The treatment suggestions below are well researched and have proven to provide substantial heel pain relief, especially if the problem has only come about in recent weeks or months.

Rest / reduced activity

Minimise walking and standing on your feet, giving the inflamed tissue under the foot a chance to recover. The body is capable of healing itself, provided you give it some rest. Avoid any running, sports, walking long distances etc

Anti-inflammatory medication and ice therapy

Anti-inflammatories such ibuprofen will help reduce the inflammation of the plantar fascia, thus providing (temporarily) pain relief. You can also apply an ice pack directly onto the heel for about 5-10 minutes. This will help cool down the inflammation and give provide some relief.

Daily exercises

Many people have tightness in their calf muscles and achilles tendons (at the back of the heel). This tightness hampers your natural walking pattern and places tension on the plantar fascia. Flexible foot and leg muscles are important in the treatment and prevention of most foot complaints.

Supporting the feet with orthotic insoles

Orthotic shoe inserts are recommended by most medical practitioners, as part of an effective heel pain treatment regime. This is because orthotics address the cause of heel complaints: i.e. incorrect foot biomechanics. Developed by podiatrists, Footactive orthotics support the arches and correct faulty foot mechanics. As a result, the insoles will release the tension placed on the plantar fascia, allowing the inflamed tissue to heal itself. Today, Footlogics orthotics are used by podiatrists, chiropodists and physiotherapists across the UK and have helped many thousands of heel pain sufferers.

Recommended orthotics for heel pain:

  • Footactive Comfort +

                               £19.95 per pair
  • Footactive Casual +

                               £18.95 per pair
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Summary

  • Symptoms: pain in the heel, especially in the morning
  • Causes: Plantar Fasciitis - inflammation of the plantar fascia, as a result of over-pronation
  • Treatment: exercises + orthotics