Heel Pain
Heel pain is one of the most common forms of foot pain in adults. It often occurs as a result of daily activities and exercise. The heel bone (calcaneus) is the largest bone in the foot and the heel is the first part of the foot to contact the ground during walking.
Two structures located on the bottom (sole) of the foot are primarily associated with heel pain: the plantar fascia, a band of fibrous connective tissue, and the flexor digitorum brevis muscle, which supports the arch and flexes the four small toes.
Normally, as the foot absorbs the weight of the body during walking, the arch begins to flatten and the plantar fascia and the flexor digitorum brevis muscle maintain the arch and stabilize the foot.
Gait abnormalities can cause inflammation of the structures attached to the heel bone, resulting in heel pain. Inflammation of the plantar fascia, called plantar fasciitis, is the most common cause of heel pain.
Plantar fasciitis often causes pain that is more severe following a period of rest (e.g., after sleeping). This condition is also called post-static dyskinesia, which means "pain after rest."
Sometimes, muscle strain and tension (usually on the flexor digitorum brevis) pulls a piece of bone away from the calcaneus, causing a heel or bone spur. Heel spurs can irritate nerves and cause pain.
Signs and Symptoms
Heel pain varies in severity. In most cases of plantar fasciitis, pain is more severe following periods of inactivity (e.g., in the morning), subsides with activity, and increases in severity with prolonged activity. This occurs because inactivity causes the muscles in the foot to tighten, increasing the strain on the plantar fascia and aggravating heel spurs, if they are present. The muscles stretch with mild activity and the heel pain subsides. Prolonged or strenuous activity increases inflammation and the severity of heel pain.
Other symptoms of plantar fasciitis include swelling, redness, and heat.
Treatment
If you should be bothered by any or all of the symptoms mentioned, the first step in treatment can be tried at home. Often, relief can be attained by:
- Padding the heel with a soft, foam-rubber material
- Wearing supportive shoes with a thick rubber heel
- Placing ice against the bottom of the heel to reduce swelling
- Stretching the calf muscles
Treatment of the "heel-spur syndrome" -- or plantar fasciitis is two-fold. First, the inflammation responsible for the discomfort needs to be reduced, and secondly, the abnormal motion of the foot needs to be controlled. Reduction of the inflammation can sometimes be accomplished simply by reducing the amount of motion. This can be achieved temporarily with taping or strapping the feet.
If symptoms resolve fairly quickly, then many times no further treatment is needed unless there is another flare-up. Oral anti-inflammatory medications often are helpful in reducing this inflammation and occasionally an injection of local anesthesia and cortisone into the inflamed area is needed to calm it down.
Controlling the abnormal motion is the key to preventing reoccurrence of this syndrome, and the most effective means of doing this is with the use of a custom-fitted orthotic device.
When the condition has existed so long that these methods of treatment fail to resolve the symptoms, surgical treatment is sometimes necessary to afford permanent relief.
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2:24Heel Pain Stretching Helpby myrundoc250,977 views
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