Do You Have Problems Putting Your Foot Down?

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The Cause of Heel Pain

The most common cause of heel pain is plantar fascitis, otherwise more commonly known as heel spur. Basically, plantar fascitis is fibrous tissue which runs along the bottom surface of the foot, all the way from the heel to the toes. If you have plantar fascitis it basically means that the plantar fascia is inflamed.

If you have had the condition for a long time, calcium usually deposits at the point where the plantar fascia meets the heel. On an x ray, this produces an appearance of a thorn like heel spur. The actual spur is not painful; it is the inflammation which makes the condition painful.

The pain varies but generally includes a dull ache felt most of the time, followed by sharp pain in the center of the heel or on the inside margin of the heel. The pain is usually also worse when you have just woken up in the morning and it is not helped by the sufferer wearing thin soled shoes!  The main causes of this condition include: 

Excessive Force on the Foot

This condition is more common in middle aged and overweight people as they often put a lot more pressure onto the heel. Pregnant women are also at risk of the condition as they tend to put on weight quite quickly, and again there is a lot of pressure on the heel.

Taking The Foot by Surprise

If you are not used to walking very far or for very long, and you suddenly change jobs or your lifestyle pattern to include long periods of walking around, you could easily suffer from plantar Fascitis. The foot needs time to adjust to things, and the constant, unexpected pressure onto the heel could easily cause plantar fascitis.

Existing Medical Problems

The condition can also be caused by various different medical conditions such as arthritis and tight plantar Fascia (which is generally tight calf muscles). Also any problems with walking could also trigger the condition. 

Overall, there are many different reasons which could cause the condition. However, none of them help to relieve the pain once it has been triggered!

Ways to Treat Heel Pain

Usually, physical therapy helps a lot with conditions like this one, as does other conservative therapies such as medication and custom orthotics. However, in some cases surgery may be needed in order to remove the bone spur, or to release the fascia away from the heel bone where it was pulling away.  If invasive surgery is not your kind of thing, there is a fairly new treatment called EndoScopic Plantar Fasciotomy which helps to treat fascia inflammation. The new technique involves making a very small incision into the heel area, and placing the endoscope into the heel area. This then projects a large image back to a television screen, where the surgeon has a pretty good idea of what is going on within the heel. 

The EndoScopic Plantar Fasciotomy is done under local anesthetic and unlike other, more invasive techniques, it does not take as long. Usually straight after the treatment, patients are able to walk normally and they can put pressure onto the heel with no problems.

If missing work is a worry for you, then you will be glad to know that this type of surgery has minimal effects and you should be back to work within three days. You will be given pain control, but usually not much is needed.   Overall, most of us leave problems such as heel pain, for long periods of time before getting it diagnosed. It is always better to get these things sorted out as soon as possible. If left, the problem only gets worse and you may end up having surgery when it could have been avoided earlier.

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Author: Piyawut Sutthiruk

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