Plantar Fasciitis (heel pain)

Chronic heel pain...there is a solution

Overall, about 15 percent or more of the patients I see have some sort of heel pain. There is a wide variety of conditions that can cause chronic heel pain. Each condition has its own specific characteristics. One such condition which commonly causes chronic heel pain is called plantar fasciitis (plan-tar fash-i-tiss) which is an inflammation of the long ligament on the bottom of the foot. This ligament "tents" up the arch of the foot, much like a bowstring and can be seen in the arch of most people when the big toe is raised. Many people with this condition believe they have a "heel spur" that hurts, but the inflammation in the ligament is typically the real problem. The pain in the heel and arch with this condition is classically at it its worst when initially bearing weight on the foot in the morning or when standing after sitting for a prolonged period. In recent years, a variety of new, effective treatments for this condition have been added. Various forms of physical therapy, injections, special devices called night splints or orthotics, or a type of treatment called orthotripsy, which is a high-intensity ultrasound "shockwave" can all be considered. Surgery is rarely necessary, but may in a few cases be considered when all conservative treatments are thoroughly exhausted.

If rest, ice, over-the-counter medicines or arch supports do not provide relief of a chronically painful heel, a visit to our office may be needed. Other conditions may also be the culprit such as Achilles tendonitis (inflammation of the main tendon from the calf muscles), stress fractures (a type of overuse injury), tarsal tunnel syndrome (similar to carpal tunnel syndrome), bursitis (inflammation of a fluid-filled sacs that sit alongside different tendons), and arthritis are a few of the other many problems that could be causing the in the heel. The most important thing is to carefully determine the cause of the pain to be able to provide properly directed treatment.