Every mile you walk puts tons of stress on each foot. Your feet can handle a heavy load, but too much stress pushes them over their limits. When you pound your feet on hard surfaces playing sports or
wear shoes that irritate sensitive tissues, you may develop Heel Pain
, the most common problem
affecting the foot and ankle. A sore Heel will usually get better on its own without surgery if you give it enough rest. However, many people try to ignore the early signs of Heel pain and keep on
doing the activities that caused it. When you continue to walk on a sore Heel, it will only get worse and could become a chronic condition leading to more problems.Surgery is rarely necessary.
Long standing inflammation causes the deposition of calcium at the point where the plantar fascia inserts into the heel. This results in the appearance of a sharp thorn like heel spur on x-ray. The
heel spur is asymptomatic (not painful), the pain arises from the inflammation of the plantar fascia.
Plantar fascia usually causes pain and stiffness on the bottom of your heel although some people have heel spurs and suffer no symptoms at all. Occasionally, heel pain is also associated with other
medical disorders such as arthritis (inflammation of the joint), bursitis (inflammation of the tissues around the joint). Those who have symptoms may experience ?First step? pain (stone bruise
sensation) after getting out of bed or sitting for a period of time. Pain after driving. Pain on the bottom of your heel. Deep aching pain. Pain can be worse when barefoot.
To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain
other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are
found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
Non Surgical Treatment
Calf stretch, Heel cups/lifts, ice, night splint, physical therapy, activity modification. Sometimes immobilization in a cast or boot may be necessary. Topical creams, such as Voltaren or Ketoprofen,
have been found to have some benefit. In some cases, the tendon may become degenerative (tendonosis). In these instances, treatment is more difficult. Prolonged periods of immobilization and physical
therapy may be required. In resistant cases, surgical debridement of the tendon may be necessary. Rarely does a symptomatic achilles tendon rupture. Most achilles ruptures are not associated with
prodromal symptoms. Achilles ruptures are more common in men and "weekend warriors," ie middle aged men who like to play sports (soccer, softball, basketball) on the weekends.
When a diagnosis of plantar fasciitis is made early, most patients respond to conservative treatment and don?t require surgical intervention. Often, when there is a secondary diagnosis contributing
to your pain, such as an entrapped nerve, and you are non-responsive to conservative care, surgery may be considered. Dr. Talarico will discuss all options and which approach would be the most
beneficial for your condition.
Being overweight can place excess pressure and strain on your feet, particularly on your heels. Losing weight, and maintaining a healthy weight by combining regular exercise with a healthy, balanced
diet, can be beneficial for your feet. Wearing appropriate footwear is also important. Ideally, you should wear shoes with a low to moderate heel that supports and cushions your arches and heels.
Avoid wearing shoes with no heels.