Heel Pain, Heel Spurs and Plantar Fasciitis explained...

"I get out of bed in the morning and feel a sharp pain in the centre of my heel with my first steps.."

Sounds familiar? Heel pain is by far the most common foot problem in the UK, with many thousands of people suffering. Fortunately, for most people effective and affordable treatment solutions are now available, without the need for to see a doctor or specialist.

Symptoms

Most people experience heel pain with their first steps in the morning, after getting out of bed. It is presented by a sharp stabbing pain at the bottom or front of the heel bone. The pain varies in severity. In most cases, heel pain is more severe following periods of inactivity (e.g. early in the morning or after sitting for a long period). After walking around for a while the sharp pain subsides and is replaced by a dull ache.

What exactly causes heel pain?

The most common cause of heel pain and heel spurs is Plantar Fasciitis. This is Latin for inflammation of plantar fascia. The plantar fascia is the flat band of tissue under the foot that connects your heel bone to your toes. It supports the arch of your foot. Normally, the fascia is flexible and strong.  However, due to factors such as abnormal stress, excessive weight, age and poor foot function painful stretching and micro-tearing of the plantar fascia tissue occurs leading 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.

Continuous pulling of the fascia at the heel bone, eventually may lead to the development of bony growth on the heel. This is called a heel spur.

Over-stretching of the plantar fascia is more likely to happen if:

- you suffer from over-pronation (lowering of the arches)

- you stand or walk on hard surfaces for long periods

- you do a lot of running and/or sports

- you are overweight or pregnant

- you have tight calf muscles

- you are over 50 years of age

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
Inflammation at the heel

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. Read more about these exercises here..

Suporting 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, Footlogics 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.
Plantar Fasciitis before and after

Recommended orthotics for heel pain:
Other common conditions: