HEEL PAIN

Heel pain is a common foot problem, usually caused when the heel is pulled by muscles and ligaments that support the arch of the foot.

Plantar fascitis, a form of heel pain, is the inflammation of the plantar fascia- the strong tissue that connects the heel to the base of the toes-- which maintains the arch of the foot. It is caused by prolonged standing which maintains the arch of the foot. It is caused by prolonged standing and repetitive stress from walking, running or intensive athletic activity.

Heel pain also can be caused by nerve entrapment, a stress fracture of the heel bone, an inflammatory disease like rheumatism and gout or a bruise in the fat pad under the heel.

Symptoms include dull and intermittent pain that often becomes sharp and persistent. The pain is usually worse in the morning or when walking, but becomes less intense later in the day. Heel pain is prevalent inpeople who are overweight, have flat feet or who are extremely active in athletics or high impact activities.

Ninety-five percent of patients will respond to conservative treatment without surgery, however, it can take up to one year for a patient to be free of symptoms. Heel pain is treated conservatively with:

• properly fitted, rubber or soft soled shoes that cushion impact to the bottom of the foot
• anti-inflammatory medications
• anti-inflammatory creams
• shoe modification or inserts for arch support
• massaging with ice (5-7 minutes) or use of cold packs (20 minutes)
• limitation of activities
• stretching exercises for the Achilles tendon and calf muschles
• warm water soaks with Epsom salts for 10 minutes twice a day or a whirlpool foot bath
• hydrocortisone injection

If conservative treatment doesn't help, an orthopaedic surgeon may recomment a night splint, cast or brace to immobilize the foot. If conservative treatments are unsuccessful, your orthopaedic surgeon may recommend a surgical treatment.

Source: Orthopaedics Update '96, Oct 15, 1996. American Academy of Orthopaedic Surgeons.