One of the most common foot problems seen by physicians is heel pain. Heel
pain that occurs in adult patients is most commonly caused by a condition known
as plantar fasciitis. This condition is sometimes also known as a heel spur.
Heel pain can also be caused by other factors, such as:
- stress fracture
- nerve entrapment
- cyst in the heel bone
It is important to see an appropriate specialist for heel pain because there
are so many things that can cause it. The specialist will be able to order the
appropriate studies, distinguish between the possibilities, and determine what
is causing the heel pain.
What causes plantar fasciitis?
This problem is caused by an inflammation (swelling) of the plantar fascia (a
band of tissue/ligament that extends from the heel to the toes) on the bottom of
the foot. Several factors contribute to plantar fasciitis. These include:
- having a very high arched foot or a flat foot
- wearing non-supportive footwear on hard-to-flat surfaces for prolonged
periods of time
- physical factors such as obesity
What are the symptoms of plantar fasciitis?
Symptoms usually include pain on the bottom of the heel. The pain is usually
worse upon arising in the morning or after sitting for a period of time. The
pain will generally decrease after a short period of walking. The pain usually
becomes worse over a period of months if not treated.
How is plantar fasciitis diagnosed?
Diagnosis is made after the specialist makes a thorough physical examination
of the foot, takes note of the history and course of the problem, and orders
appropriate diagnostic tests. These tests may include X-rays, bone scans, or
magnetic resonance imaging (MRI) when needed. Occasionally, spurs on the bottom
of the heel will be noted on X-rays; this is not usually the source of the pain.
How is plantar fasciitis treated?
Treatment of plantar fasciitis usually begins with appropriate stretching
exercises (to stretch out the calf and plantar fascia.). Other treatments might include:
- avoidance of walking barefoot
- massage therapy
- ice application to the area
- limited physical activity for a time
- using appropriate inserts or orthotics
- modifying shoe gear
- using medications like non-steroidal anti-inflammatory agents
- losing weight
Occasionally, if none of the above solutions work, surgery may be an option.
In general, any surgery should be avoided until all of the above options have failed.
In general, heel pain can be treated conservatively without surgical
intervention. Remember that once pain has been alleviated, you may still need to
continue appropriate supportive shoes and stretching exercises to prevent recurrence.
American Academy of Orthopaedic Surgeons. Heel Pain.
orthoinfo.aaos.org. Accessed 1/4/11
American College of Foot and Ankle Surgeons. Foot Health Facts: Heel Pain (Plantar Fascitis)
www.foothealthfacts.org Accessed 1/4/11
American Podiatric Medical Association. Foot Health: Heal Pain.
www.apma.org. Accessed 1/4/11
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/4/2011…#14709