What’s Causing Your Heel Pain

The most common condition that affects the foot is heel pain. The characteristic pain affecting the heel is variable. It could be burning pain, slow progressing pain, or striking pain when the affected heel is used. In some cases, especially when a patient has chronic heel pain, the pain can occur even at rest.

In most cases of heel pain, the plantar fascia is involved. There could be a pathologic finding or damage to plantar fascia or irritation and inflammation to the surrounding tissues at the heel bone where the plantar fascia attaches.

The plantar fascia is a strong band of fibrous tissue found underneath the foot. It attaches to the calcaneous or heel bone to the balls of the foot. It is responsible in maintaining the arch of the foot which is very important in the biomechanics of the foot.

The plantar fascia is constantly under tremendous pressure when walking, running, lifting weights, or anything that involves using the foot. For this reason, it is not surprising that this structure develop tiny tears that can accumulate over the years. These tiny micro tears can cause mild to severe heel pain. This is the reason why the elderly commonly develop this type of foot pain. Younger individuals also develop premature fascia tears, especially people who are active in sports like runners. Plantar fasciitis is the medical term which means irritation and inflammation of the plantar fascia.

Heel pain is a very common condition. About 10% of the human population will experience at least one episode of heel pain at some point in their lives. Individuals mostly affected by heel pain are:

•  The elderly around the age 40 to 60 years old.
•  Active individuals who regularly run or jog.
• Athletes especially runners, basketball players, volleyball players. 
• Obese or overweight
•  Diabetics

Treatment of heel pain caused by plantar fasciitis focuses on alleviating the inflammation and irritation of the plantar fascia. The easiest way to treat heel pain is by following the R.I.C.E. method.

•   Rest. Immobilizing and allowing the foot to rest promotes wound healing. Resting alone can treat the acute or early stages of heel pain.  This heals the micro tears and damage done to the plantar fascia
•  Ice. Cold stimuli help reduce inflammation and can also decrease pain
• Compression. Compression bandages help immobilize the foot and also reduce further swelling of the foot
• Elevation. Elevating the foot above the heart prevents pooling of blood. This significantly reduce swelling therefore also a great way to reduce pain

Other treatments include calf stretches, steroid injections, devices that support the foot like orthoses or shoes that provide cushion and support for the foot.

If the above treatments still do not alleviate pain, then other modalities like ESWT or minimal surgery is required especially for chronic heel pain.