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What Causes Heel Serious Pain

June 29, 2017
Overview

Painful Heel

The plantar fascia is a broad fan shaped strap of strong body tissue which stretches from the bottom of the heel bone to the ball of the foot. It helps to hold the foot bones and joints in place. When it is over stressed (over stretched) typical symptoms occur. The heels hurt most of all first thing in the morning or after a period of rest. The heels are also very sore after standing for a long time.

Causes

Pain in the foot can be due to a problem in any part of the foot. Bones, ligaments, tendons, muscles, fascia, toenail beds, nerves, blood vessels, or skin can be the source of foot pain. The cause of foot pain can be narrowed down by location and by considering some of the most common causes of foot pain. Plantar fasciitis is the most common cause of heel pain. The plantar fascia, a band of tough tissue connecting the heel bone to the toes, becomes irritated or inflamed. Heel pain, worst in the morning when getting out of bed, is the most common symptom. Arch pain may also be present.

Symptoms

See your doctor immediately if you have Severe pain and swelling near your heel. Inability to bend your foot downward, rise on your toes or walk normally. Heel pain with fever, numbness or tingling in your heel. Severe heel pain immediately after an injury. Schedule an office visit if you have. Heel pain that continues when you're not walking or standing. Heel pain that lasts more than a few weeks, even after you've tried rest, ice and other home treatments.

Diagnosis

To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.

Non Surgical Treatment

Initially, treatment will consist of adding support to the foot, including better shoes and an over-the-counter arch supports and/or insoles; resting from the sport or activity that aggravates the problem; stretching the calf and arch muscles; taking anti-inflammatory; and using ice and massage to reduce inflammation. You can ice and message your muscles simultaneously by freezing a water bottle filled with water and using it to massage your foot by rolling it underneath your foot for five to 10 minutes at least two times per day. It is not unusual for symptoms of plantar fasciitis to persist for six to 12 months despite treatment.

Surgical Treatment

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.

heel cups for plantar fasciitis

Prevention

Painful Heel

It may not be possible to prevent all cases of heel pain. However, there are some easy steps that you can take to avoid injury to the heel and prevent pain. Whenever possible, you should wear shoes that fit properly and support the foot, wear the right shoes for physical activity, stretch your muscles before exercising, pace yourself during physical activity, maintain a healthy diet, rest when you feel tired or when your muscles ache, maintain a healthy weight.

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