What Causes Heel Discomfort To Appear

Heel Discomfort

Overview

Plantar fasciitis is a dull to severe pain in your heel caused by a strain and inflammation of your plantar fascia. The plantar fascia is a scientific name for “foot tissue”. This particular tissue is a ligament attached at one side to the heel bone. At the other side, the tissue fans out to attach at the base of each of your five toes. Plantar fasciitis is the name for the condition that develops when that tissue becomes inflamed. When the plantar fascia is excessively stretched, micro-tears can occur, causing this swelling and subsequent pain.




Causes

Repeated small injuries to the fascia (with or without inflammation) are thought to be the cause of plantar fasciitis. The injury is usually near to where the plantar fascia attaches to your heel bone. You are more likely to injure your plantar fascia in certain situations. For example, if you are on your feet for a lot of the time, or if you do lots of walking, running, standing, etc, when you are not used to it. (Plantar fasciitis may be confused with 'Policeman's heel', but they are different. Policeman's heel is plantar calcaneal bursitis - inflammation of the sack of fluid (bursa) under the heel bone. This is not as common as plantar fasciitis.) Also, people with a sedentary lifestyle are more prone to plantar fasciitis. If you have recently started exercising on a different surface, for example, running on the road instead of a track. If you have been wearing shoes with poor cushioning or poor arch support. If you are overweight this will put extra strain on your heel. If there is overuse or sudden stretching of your sole. For example, athletes who increase running intensity or distance; poor technique starting 'off the blocks', etc. If you have a tight Achilles tendon (the big tendon at the bottom of your calf muscles above your heel). This can affect your ability to flex your ankle and make you more likely to damage your plantar fascia. Often there is no apparent cause for plantar fasciitis, particularly in older people. A common wrong belief is that the pain is due to a bony growth or 'spur' coming from the heel bone (calcaneum). Many people have a bony spur of the heel bone but not everyone with this gets plantar fasciitis.




Symptoms

Among the symptoms for Plantar Fasciitis is pain usually felt on the underside of the heel, often most intense with the first steps after getting out of bed in the morning. It is commonly associated with long periods of weight bearing or sudden changes in weight bearing or activity. Plantar Fasciitis also called “policeman’s heel” is presented by a sharp stabbing pain at the bottom or front of the heel bone. In most cases, heel pain is more severe following periods of inactivity when getting up and then subsides, turning into a dull ache.




Diagnosis

Your GP or podiatrist (a healthcare professional who specialises in foot care) may be able to diagnose the cause of your heel pain by asking about your symptoms and examining your heel and foot. You will usually only need further tests if you have additional symptoms that suggest the cause of your heel pain is not inflammation, such as numbness or a tingling sensation in your foot, this could be a sign of nerve damage in your feet and legs (peripheral neuropathy) your foot feels hot and you have a high temperature (fever) of 38C (100.4F) or above - these could be signs of a bone infection, you have stiffness and swelling in your heel, this could be a sign of arthritis. Possible further tests may include blood tests, X-rays - where small doses of radiation are used to detect problems with your bones and tissues, a magnetic resonance imaging (MRI) scan or ultrasound scan, which are more detailed scans.




Non Surgical Treatment

Night splints are treatment that can help stretch your calf and the arch of your foot. Night splints are a type of brace that holds your foot in a flexed position and lengthens the plantar fascia and Achilles tendon overnight. This can prevent morning pain and stiffness. Special orthotics, or arch supports, for your shoes may help alleviate some of the pain by distributing pressure, and can prevent further damage to the plantar fascia. A boot cast may be used to immobilize your foot and reduce strain while the plantar fascia heals. A boot cast looks like a ski boot and can be removed for bathing.

Feet Pain




Surgical Treatment

Surgery should be reserved for patients who have made every effort to fully participate in conservative treatments, but continue to have pain from plantar fasciitis. Patients should fit the following criteria. Symptoms for at least 9 months of treatment. Participation in daily treatments (exercises, stretches, etc.). If you fit these criteria, then surgery may be an option in the treatment of your plantar fasciitis. Unfortunately, surgery for treatment of plantar fasciitis is not as predictable as a surgeon might like. For example, surgeons can reliably predict that patients with severe knee arthritis will do well after knee replacement surgery about 95% of the time. Those are very good results. Unfortunately, the same is not true of patients with plantar fasciitis.

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