The most common cause of heel pain is plantar fasciitis, or heel spur syndrome. With a thorough medical history and examination of your foot and ankle, your podiatrist can differentiate plantar fasciitis from other causes of heel pain such as a stress fracture, arthritis, tendonitis, or an irritated nerve.

Symptoms of Plantar Fasciitis:

  • Pain in the bottom of the heel or into the arch.
  • Worst with the first few steps in the morning or towards end of the day
  • Swelling

What Is Plantar Fasciitis?

Plantar fasciitis, or heel spur syndrome, occurs when the thick band of connective tissue on the bottom of the foot (the plantar fascia) becomes inflamed.  The plantar fascia attaches at the heel bone and fans out to the ball of the foot. Sometimes a bone spur forms at the attachment of the fascia on to the heel bone, though this is rarely the source of pain. People with very flat or very high arched feet are more prone to this problem. It can also develop in people who wear non-supportive shoes or are on their feet on hard surfaces for prolonged periods of time.

Initial Treatment:

-Stretch your calf muscles.

-Ice the affected area for 15 minutes at a time, several times a day. Place a thin towel between your heel and the ice pack to protect your skin.

-Wear supportive shoes with good arch support. A slightly raised heel can also be helpful.

-Avoid going barefoot.

-Rest: Decrease your activities to allow your foot to heal.

-Medications: Oral NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen can reduce pain and inflammation.

 

If you still are experiencing pain after several weeks, see your foot and ankle surgeon.  He or she may take an x-ray of your foot and add in one or more of the following treatments:

 

Second Line Treatment:

-Padding/taping/strapping your foot to temporarily relieve strain on the plantar fascia.

-Orthotics: Devices that fit in your shoes to better align your foot and take stress off the plantar fascia.

-Injections: Corticosteroid injections can help reduce inflammation right at the source of your pain.

-Night splints: A special boot worn at night to help keep your foot and calf stretched out while sleeping.

-Physical therapy: Exercises and other modalities may be used.

-EPAT (Extracorporeal Pulse Activation Technology)/Shockwave Treatment: An alternative to surgery that accelerates the healing process.

-Surgery: In rare cases that fail conservative treatment, plantar fasciotomy surgery can be performed.