As anyone who has ever had foot pain can tell you, when your feet hurt, you hurt all over. ?The feet are the foundation of our ?building,? or body,? says Craig Gastwirth, a podiatrist at Podiatry Examiners of Michigan in Detroit. ?If there?s a problem with that foundation, everything else - knees, hips and back - is thrown off.? Heel pain, typically caused by plantar fasciitis, is the No. 1 reason people visit a podiatrist, says Dr. Gastwirth. Plantar fasciitis, inflammation of a thick band of connective tissue called the plantar fascia, which runs along the sole from the bottom of the heel bone to the toes, can feel like the arch of the foot is tearing.
While heel pain has many causes, it is usually the result of poor biomechanics (abnormalities in the way we walk). This can place too much stress on the heel bone and the soft tissues attached to it. The stress may result from injury, or a bruise incurred while walking, running or jumping on hard surfaces: wearing poorly constructed footwear : or being significantly over weight. Systemic diseases such as arthritis can also contribute to heel pain.
Initially, this pain may only be present when first standing up after sleeping or sitting. As you walk around, the muscle and tendon loosen and the pain goes away. As this problem progresses, the pain can be present with all standing and walking. You may notice a knot or bump on the back of the heel. Swelling may develop. In some cases, pressure from the back of the shoe causes pain.
Your doctor will perform a physical exam and ask questions about your medical history and symptoms, such as have you had this type of heel pain before? When did your pain begin? Do you have pain upon your first steps in the morning or after your first steps after rest? Is the pain dull and aching or sharp and stabbing? Is it worse after exercise? Is it worse when standing? Did you fall or twist your ankle recently? Are you a runner? If so, how far and how often do you run? Do you walk or stand for long periods of time? What kind of shoes do you wear? Do you have any other symptoms? Your doctor may order a foot x-ray. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot. Your doctor may recommend a night splint to help stretch your foot. Surgery may be recommended in some cases.
Non Surgical Treatment
Initial treatment consists of rest, use of heel cushions to elevate the heel (and take tension off the Achilles), stretching and applying ice to the area. You can ice and stretch the area simultaneously by filling a bucket with ice and cold water and placing the foot flexed with the toes upward so that the Achilles tendon region is bathed in the cold water for 10 to 15 minutes twice a day. The Achilles region can also become inflamed around the tendon, called paratendinosis. This condition can be treated with the ice bucket stretching, rest and physical therapy. Another area that is commonly subjected to problems is the attachment of the Achilles near or on the heel bone. The heel (calcaneus) itself can have an irregular shape to it, causing irritation to the Achilles as it twists over the region and inflames the bursa, a naturally occurring cushion. Shoes can often aggravate this condition. Sometimes over-stretching, such as the Achilles stretch with the knee bent, can irritate the tendon and cause a bursitis. Prescription foot orthoses can help reduce the torque of the Achilles tendon in these types of cases. Often, the Achilles tendon calcifies near its attachment due to constant torque and tension. Repetitive stress can cause this calcific spur to crack, creating a chronic inflammatory situation that can require surgery. All of these types of chronic Achilles tendinosis that require surgery are successfully treated in over 90 percent of the cases. As with most foot surgery, complete recovery can take up to a year. Though heel pain is common and can be chronic, it does not have to be your weakness (as was the case with the warrior Achilles from Greek mythology).
At most 95% of heel pain can be treated without surgery. A very low percentage of people really need to have surgery on the heel. It is a biomechanical problem and it?s very imperative that you not only get evaluated, but receive care immediately. Having heel pain is like having a problem with your eyes; as you would get glasses to correct your eyes, you should look into orthotics to correct your foot. Orthotics are sort of like glasses for the feet. They correct and realign the foot to put them into neutral or normal position to really prevent heel pain, and many other foot issues. Whether it be bunions, hammertoes, neuromas, or even ankle instability, a custom orthotic is something worth considering.
what does a heel spur look like
Prevention of heel pain involves reducing the stress on that part of the body. Tips include. Barefeet, when on hard ground make sure you are wearing shoes. Bodyweight, if you are overweight there is more stress on the heels when you walk or run. Try to lose weight. Footwear, footwear that has material which can absorb some of the stress placed on the heel may help protect it. Examples include heel pads. Make sure your shoes fit properly and do not have worn down heels or soles. If you notice a link between a particular pair of shoes and heel pain, stop wearing them. Rest, if you are especially susceptible to heel pain, try to spend more time resting and less time on your feet. It is best to discuss this point with a specialized health care professional. Sports, warm up properly before engaging in activities that may place lots of stress on the heels. Make sure you have proper sports shoes for your task.