Is Heel Pain Keeping You Off Your Feet?

Plan­tar fasci­itis typ­i­cal­ly affects adults aged 40 – 60. It is most often caused by a com­bi­na­tion of overuse and poor arch sup­port. It results in injury of the plan­tar fas­cia in the heel area, lead­ing to inflam­ma­tion and pain. The plan­tar fas­cia is a thick band of tis­sue that lines the bot­tom of your foot; it is anchored to the base of the heel bone and attach­es to ball of your foot.

If you are expe­ri­enc­ing a mild pulling or tight sen­sa­tion on the bot­tom of your heel that is worse when you go from sit­ting to stand­ing, after exer­cis­ing or when stand­ing for long peri­ods of time there are sev­er­al treat­ment meth­ods you can try at home.

Home reme­dies for reliev­ing the pain of plan­tar fasci­itis:
a. Gen­tle stretch­ing in the morn­ing and evening with sim­ple and slow ​“point and flex” exer­cis­es, mak­ing sure to stop if pain results.
b. Arch sup­port is impor­tant and adding an over the counter med­ica­tion option is a fine ini­tial method for treat­ing the prob­lem.
c. Make job-site mod­i­fi­ca­tions if you stand on your feet for long peri­ods at work. Request a cush­ioned mat to stand on and choose footwear with sup­port­ive arch­es.
d. Work to main­tain a healthy weight for your height, age and gen­der
e. Avoid flat shoes, flip flops or walk­ing bare­foot
f. Low­er your impact lev­el dur­ing exer­cise or switch to cross-train­ing/bik­ing
g. Ice the bot­tom of your feet gen­tly with a frozen water bot­tle each evening for 10 – 15 min­utes. Take care to not apply ice direct­ly to skin.
h. Take over the counter pain relief med­ica­tions if tol­er­at­ed and as directed.

Ignor­ing plan­tar fasci­itis and ​“suf­fer­ing through the pain” will like­ly lead to a longer and more involved treat­ment plan. Com­pen­sat­ing for your pain can lead to oth­er mus­cu­loskele­tal con­di­tions. There­fore, if con­ser­v­a­tive home care is not reliev­ing your heel pain it is impor­tant to seek an eval­u­a­tion with a board-cer­ti­fied podi­a­trist. Your podi­a­trist will work with you to design an aggres­sive treat­ment plan that fits your indi­vid­ual needs and lifestyle.

Treat­ment options for plan­tar fasci­itis under the care of a podi­a­trist:
Often, your podi­a­trist will rec­om­mend a com­bi­na­tion of sev­er­al treat­ment meth­ods at one time. Because every patien­t’s lifestyle and dai­ly activ­i­ties vary, there are dif­fer­ent treat­ment plans avail­able that fit each indi­vid­u­al’s needs. Your physi­cian will work with you to under­stand your par­tic­u­lar needs and activ­i­ty lev­el and will pre­scribe the most appro­pri­ate plan that will resolve the inflam­ma­tion in your foot.

• X‑Rays may be obtained to rule out heel spurs or oth­er struc­tur­al conditions.
• Cor­ti­cos­teroid injec­tions are typ­i­cal­ly the first course of action for rapid relief. These injec­tions usu­al­ly begin to alle­vi­ate pain with­in 24 hours.
• Arch sup­port is key; gener­ic or even­tu­al­ly cus­tom orthotics may be fab­ri­cat­ed if needed.
• Phys­i­cal Ther­a­py (your treat­ment com­bi­na­tion may include exer­cis­es to increase foot flex­i­bil­i­ty, man­u­al ther­a­py, kine­sio­tape, ultra­sound and electrical-stim).
• Cus­tom orthot­ic inserts to cor­rect struc­tur­al prob­lems in your foot anatomy
• Immo­bi­liza­tion or cast­ing tech­niques are rarely used but can pro­vide relief in extreme cases.
• The need for surgery and oth­er non-inva­sive tech­niques are not like­ly in most indi­vid­u­als, but may be nec­es­sary if con­ser­v­a­tive care fails.
• Night splints are over-the-counter devices that aid in stretch­ing the foot and fas­cia while sleep­ing. These may be dif­fi­cult for some patients to tol­er­ate, but very help­ful to oth­er patients.

A podi­a­trist will also decide if there are any oth­er con­di­tions that may be con­tribut­ing to your heel pain. For exam­ple, bone spurs, bur­si­tis and Achilles ten­dini­tis may present in a sim­i­lar man­ner as plan­tar fasci­itis. A thor­ough exam will iden­ti­fy and con­firm the con­di­tion with which you are struggling.

Tak­ing con­trol of your foot pain and work­ing with a physi­cian is the best course of action, non­sur­gi­cal treat­ments typ­i­cal­ly can pro­vide pain relief. Con­tact a mem­ber of the DuPage Med­ical Group Podi­a­try depart­ment at 630−510−6929 to begin plan­ning your treat­ment today.