Heel pain is usually felt either under the heel or just behind it. Heel Pain
has a prevalence of
3.6%. US studies estimate that 7% of older adults report tenderness under the heel. Plantar fasciitis is estimated to account for 8% of all running-related injuries. There are 26 bones in the human
foot, of which the heel is the largest. Pain typically comes on gradually, with no injury to the affected area. It is often triggered by wearing a flat shoe. In most cases the pain is under the foot,
towards the front of the heel. The majority of patients recover with conservative treatments within months. Home care such as rest, ice, proper-fitting footwear and foot supports are often enough to
ease heel pain. To prevent heel pain, it's recommended to reduce the stress on that part of the body.
Heel pain can have many causes. If your heel hurts, see your primary care doctor or orthopaedic foot and ankle specialist right away to determine why and get treatment. Tell him or her exactly where
you have pain and how long you've had it. Your doctor will examine your heel, looking and feeling for signs of tenderness and swelling. You may be asked to walk, stand on one foot or do other
physical tests that help your doctor pinpoint the cause of your sore heel. Conditions that cause heel pain generally fall into two main categories: pain beneath the heel and pain behind the
Usually worse with the first few steps in the morning or at the initial point of activity. The latter usually gets better with continued activity (squeaky hinge analogy). Walking, running, sprinting,
hill running and jumping will increase the pain. Often, the natural response is to walk on the outside of the foot - in supination - to lessen the stress on the plantar fascia - resulting in new
A podiatrist (doctor who specializes in the evaluation and treatment of foot diseases) will carry out a physical examination, and ask pertinent questions about the pain. The doctor will also ask the
patient how much walking and standing the patient does, what type of footwear is worn, and details of the his/her medical history. Often this is enough to make a diagnosis. Sometimes further
diagnostic tests are needed, such as blood tests and imaging scans.
Non Surgical Treatment
Shoes, orthoses, splinting and/or immobilization form the cornerstone for successful functional management of plantar fasciitis.When you take the overuse nature of plantar fasciitis into account and
attempt to re-establish the windlass mechanism of the foot, there is an enhanced potential for success. Unfortunately, too little attention has been directed to appropriately managing the shoes worn
during treatment for plantar fasciitis. Emphasising motion control and stability type athletic shoes (that provide a firm heel cup, instep rigidity, longitudinal integrity and a well-integrated shoe
upper) can help decrease excess eccentric tissue strain. The shoe also serves as a vital and functional link between an orthotic and the foot. Orthoses have long been considered to be a reliable
method for treating plantar fasciitis. Considerable debate has been waged over the benefits of over-the-counter (OTC), prefabricated and prescription foot and/or ankle orthoses. Heel cushions, heel
cups and cushioning pads appear to provide immediate pain relief for many people who have plantar fasciitis.This relief is frequently short-lived and requires other treatment modalities for
success.Neutral position taping and strapping of the foot provides temporary symptomatic relief of pain caused by plantar fasciitis. Although the functional benefits are temporary and likely do not
last longer than 10 minutes with exercise, the soft tissue compression and symptomatic relief afforded by the strapping can last for nearly a week.
Only a relatively few cases of heel pain require surgery. If required, surgery is usually for the removal of a spur, but also may involve release of the plantar fascia, removal of a bursa, or a
removal of a neuroma or other soft-tissue growth.
It is not always possible to prevent heel pain, but there are measures you can take to help avoid further episodes. Being overweight can place excess pressure and strain on your feet, particularly on
your heels. This increases the risk of damaging your feet and heels. If you are overweight, losing weight and maintaining a healthy weight by combining regular exercise with a healthy, balanced diet
can be beneficial for your feet. You can calculate your body mass index (BMI) to find out whether you are a healthy weight for your height and build. To work out your BMI, divide your weight in
kilograms by your height in metres squared. A BMI of less than 18.5 means that you are underweight, 18.5-24.9 means that your weight is healthy, 25-29 means that you are overweight, 30-40 means that
you are obese, over 40 means that you are morbidly obese. You can also use the BMI healthy weight calculator to work out your BMI.