One of the most common causes of heel pain is plantar fasciitis. Plantar fasciitis is sometimes referred to as heel spur syndrome because a heel spur is present.
While our feet can take on a lot of stress throughout the day, overuse can cause inflammation, or the plantar fascia may tear where it attaches to the heel.
The plantar fascia is a band of tissue that goes from your heel to the tip of your big toe. The plantar fascia supports the arch of your foot and absorbs most of the daily stress placed on your feet.
When plantar fasciitis occurs, the plantar fascia tissue becomes irritated and inflamed, which can cause heel pain.
At Advanced Foot & Ankle Wellness Center, Dr. Melissa Wawrzynek frequently sees patients with plantar fasciitis, offering them non-surgical and surgical treatment options to consider.
Causes of Plantar Fasciitis
People who have issues with the structure of their feet, such as overly flat or high-arched feet, are more prone to developing plantar fasciitis.
People who wear poorly structured, non-supportive shoes on hard, flat surfaces for an extended period of time are also at risk for developing plantar fasciitis. Hard surfaces place an abnormal amount of strain on the plantar fascia.
Another contributing factor for plantar fasciitis is obesity.
Symptoms of Plantar Fasciitis
People with plantar fasciitis often describe heel pain as worsening when they first get up in the morning or after sitting for long periods.
The pain decreases after a few minutes of walking because walking stretches the fascia. For some people, though, the pain subsides but returns after spending long periods of time on their feet.
Other symptoms of plantar fasciitis include:
- Pain on the bottom of the heel
- Pain in the arch of the foot
- Pain that increases over a period of months
Diagnosing Plantar Fasciitis
During your consultation, Dr. Wawrzynek will ask you to describe your symptoms and discuss your concerns. She will also examine your foot, looking for any signs of plantar fasciitis:
- A high arch
- The limited upward motion of your ankle
- Pain when you flex your foot and pressure is applied to the plantar fascia. The pain subsides when you point your toes down.
- Tenderness on the bottom of your foot in front of your heel bone
Dr. Melissa Wawrzynek will rule out various causes of heel pain to determine if you have plantar fasciitis.
Testing for Plantar Fasciitis
Various imaging modalities or x-rays may be ordered to ensure your heel pain is caused by plantar fasciitis and not some other problem. X-rays provide clear images of bone, which allows the doctor to rule out other causes of heel pain, such as fractures or arthritis.
Sometimes heel spurs are found in patients with plantar fasciitis. In such cases, this condition is known as plantar fasciitis/heel spur syndrome. Heel spurs, though, are rarely the source of the pain.
Treatment Options for Plantar Fasciitis
There is a wide range of treatment options available for plantar fasciitis. Generally, plantar fasciitis resolves within a few months after conservative, non-surgical treatment.
If nonsurgical treatment doesn’t work, surgical options are available.
Nonsurgical Treatment for Plantar Fasciitis
First-line strategies are effective treatment options for plantar fasciitis. Many of these strategies you can begin at home:
- Limit your physical activities, and give your heels a rest.
- Stretch out your calf muscles to ease your pain and help with your recovery.
- Avoid walking around barefoot, even inside. Walking without shoes puts extra stress on your plantar fascia.
- Wear supportive shoes with a slightly raised heel and good arch support. This will help reduce stress on the plantar fascia.
- Use oral nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to reduce inflammation and pain.
- Put ice on your heel for 20-minute at a time throughout the day to control inflammation. Always put a towel between the ice and your skin when icing your heel.
If you are still experiencing pain after several weeks, Dr. Wawrzynek may have you do one or more of the following:
- Physical therapy and directed exercises to provide relief.
- Removable walking cast to keep your foot immobile to allow it to rest and heal.
- Injection therapy, such as amniotic fluid injections or corticosteroid injections, relieves pain and inflammation.
- Custom orthotic devices you put in your shoes to help fix any underlying structural abnormalities in your foot.
- Pads in your shoes to reduce the impact of walking, and straps to help support your foot and reduce the strain on the fascia.
- Regenerative medicine techniques, such as biological injections, may also be an option.
Surgical Treatment Options
Most patients can resolve plantar fasciitis with non-surgical treatment options. Only a small percentage of patients require surgery for this condition. Surgery is generally only considered if you have persistent heel pain for several months and nonsurgical treatments haven’t worked.
Open surgery is one option, where the plantar fascia is cut to relieve tension. The tissue is then resected in the inside edge of the plantar fascia, leaving the outer bands of tissue intact in order to avoid developing flat feet. If heel spurs are present, they are removed to prevent potential irritation.
Other options may also be considered. Dr. Wawrzynek will review them with you during your consultation, and refer you to a surgeon if necessary.