Heel pain has multiple causes and manifests in many different ways—from dull and achy to severe, stabbing pain. Many people ignore and live with this pain in lieu of seeking medical advice, but the reasons to be proactive and see a doctor are many. Oftentimes treatment will consist of small things a patient can do to help him or herself, but sometimes medical intervention is needed, and this is when a podiatrist’s opinion is most important.
The most common cause of heel pain is Heel Spur Syndrome, or plantar fascitis. Though most people think the spur itself causes pain, the plantar fascia ligament, which attaches to the heel bone at the bottom of the foot, actually causes the pain. Due to injury, biomechanical abnormalities, or overuse, this ligament sustains micro-tears and can become calcified, causing a bone spur, or just become inflamed. Typical symptoms of Heel Spur Syndrome include pain in the morning that tends to improve with movement; pain when returning to activity after a period of rest; and increased pain after lengthy walking or exercising.
Treatment of Heel Spur Syndrome can be in the form of daily foot stretching exercises, rest, ice, anti-inflammatories, supportive shoes, and use of orthotics. Orthotics help correct improper foot function and reduce the strain and pulling on the plantar fascia. However, Heel Spur Syndrome may become chronic and therefore more difficult to cure. Treatment by a podiatrist is recommended if symptoms persist for more than two weeks. Podiatrists can utilize a multitude of conservative modalities for treatment, such as cortisone injections, custom orthotics, night splints, and physical therapy. The good news is that with comprehensive conservative treatment most heel pain will resolve. But for heel pain that is unrelenting to conservative care, a podiatrist will perform surgical intervention.
Another cause of heel pain is Tarsal Tunnel Syndrome. Tarsal Tunnel Syndrome is similar to carpal tunnel in the wrist. A nerve entrapment on the inside of the heel will cause numbness or sharp, shooting, burning pains. This occurs when a ligament, vessels, or growths impinge on the nerve. Symptoms may be persistent during rest or when on one’s feet, and weight bearing exercises, improper shoe gear, and abnormal biomechanics can all exacerbate symptoms. Similar to Heel Spur Syndrome, treatment consists of anti-inflammatories, orthotics, and cortisone injections. However, this type of conservative care is only occasionally successful, and many patients opt for surgery to release the nerve and dissolve the pain.
Patients who choose surgical intervention for heel pain should always exhaust all conservative treatments first and make an informed decision to have surgery. Fortunately, most foot surgeries are day surgeries, so there is rarely a need for the patient to spend a night in a hospital or surgical center. If you or someone you know is living with heel pain, I encourage you to seek the professional advice of a local podiatrist.
Dr. Teresa Burtoft is a board certified podiatrist who practices in North Andover, MA. She also serves as a board member on the Massachusetts Podiatric Medical Society. Dr. Burtoft can be reach at the Foot Health Center of Merrimack Valley: (978) 686-7623, www.wefixyourfeet.com.
Healing Heel Pain – March / April 2008
The most common cause of heel pain is Heel Spur Syndrome, or plantar fascitis. Though most people think the spur itself causes pain, the plantar fascia ligament, which attaches to the heel bone at the bottom of the foot, actually causes the pain. Due to injury, biomechanical abnormalities, or overuse, this ligament sustains micro-tears and can become calcified, causing a bone spur, or just become inflamed. Typical symptoms of Heel Spur Syndrome include pain in the morning that tends to improve with movement; pain when returning to activity after a period of rest; and increased pain after lengthy walking or exercising.
Treatment of Heel Spur Syndrome can be in the form of daily foot stretching exercises, rest, ice, anti-inflammatories, supportive shoes, and use of orthotics. Orthotics help correct improper foot function and reduce the strain and pulling on the plantar fascia. However, Heel Spur Syndrome may become chronic and therefore more difficult to cure. Treatment by a podiatrist is recommended if symptoms persist for more than two weeks. Podiatrists can utilize a multitude of conservative modalities for treatment, such as cortisone injections, custom orthotics, night splints, and physical therapy. The good news is that with comprehensive conservative treatment most heel pain will resolve. But for heel pain that is unrelenting to conservative care, a podiatrist will perform surgical intervention.
Another cause of heel pain is Tarsal Tunnel Syndrome. Tarsal Tunnel Syndrome is similar to carpal tunnel in the wrist. A nerve entrapment on the inside of the heel will cause numbness or sharp, shooting, burning pains. This occurs when a ligament, vessels, or growths impinge on the nerve. Symptoms may be persistent during rest or when on one’s feet, and weight bearing exercises, improper shoe gear, and abnormal biomechanics can all exacerbate symptoms. Similar to Heel Spur Syndrome, treatment consists of anti-inflammatories, orthotics, and cortisone injections. However, this type of conservative care is only occasionally successful, and many patients opt for surgery to release the nerve and dissolve the pain.
Patients who choose surgical intervention for heel pain should always exhaust all conservative treatments first and make an informed decision to have surgery. Fortunately, most foot surgeries are day surgeries, so there is rarely a need for the patient to spend a night in a hospital or surgical center. If you or someone you know is living with heel pain, I encourage you to seek the professional advice of a local podiatrist.
Dr. Teresa Burtoft is a board certified podiatrist who practices in North Andover, MA. She also serves as a board member on the Massachusetts Podiatric Medical Society. Dr. Burtoft can be reach at the Foot Health Center of Merrimack Valley: (978) 686-7623, www.wefixyourfeet.com.