Heel Pain and Plantar Fasciitis. Part 1 – Introduction to Heel Pain
You either have heel pain or know someone that does, because it is very common. In fact, there are facebook pages and groups created for communities to discuss how their managing their heel pain and provide support to each other. It is the most commonly presented soft tissue pain to podiatrist, well at least for myself anyway. If you “Dr Google” this condition you will be overwhelmed by the number of treatments available and the testimonials from #1 best sellers guaranteed to treat heel pain or your money. Unfortunately, there is no guaranteed single treatment for heel pain otherwise, every podiatrist would be utilising it. There are many medical treatments available as listed below
– Anti-inflammatories
– Rest
-Straping
– Pain killers
– Icing the heel
-Heel Cushion pads
– Cortisone Injections
-Referred pain
-Rolling heel on a ball or bottle
-Stretching the calves and plantar fascia
-Supportive footwear such as sport shoes
-Pre-made arch supports
-Physiotherapy treatment
-Acupuncture
-Podiatry dispensed Orthotics (Off the shelf and Prescription)
-Night splints
-ART (active release therapy)
-Cold laser
-PRP (platelet rich plasma) blood Injections
-Surgery
-And of course, there are many non-medical natural remedies such as Epsom salts, turmeric, fish oil.
Discussing heel pain can be like discussing lower back pain. We all seem to experience back pain at a stage in our lives, but it would be far from the truth to state we all have the same cause and treatment for our lower back pain. There are some common treatments that we commonly use such as massage, heat packs and anti-inflammatory gels but there is usually also an underlying issue that needs to be addressed, for instance, poor core stability or disk bulge. And then when the problem becomes long-standing, frequent or severe, you decide to see an expert such as a physiotherapist or chiropractor. I use the analogy of lower back pain because we can all relate, and heel pain is a similar concept in managing. Before you begin self-diagnosing and treating with “Dr Google”, ensure you see a podiatrist for an expert opinion.
I have been treating heel pain for over 14 years and losing track of how many people I have treated, I can confidently say that plantar fasciitis and heel spur is an overly used diagnosis. There are many structures under and around the heel and below is a number of all the possible diagnosis you could have for heel pain:
-Neuritis (inflammation of a nerve)
-Baxters nerve entrapment
-Tarsal tunnel syndrome
-Plantar fascial tear
-Quadratus plantae or flexor digitorum brevis muscle strain, weakness or tear
-Thick plantar fascia
-Calcaneal (heel bone) fracture, stress fracture, bruising, cyst
-Inflammation of the heel fat pad
–Bursitis (inflammed fluid sac)
-Soft tissue mass
As you can see, heel pain can be very confusing when attempting to research and self-diagnose. However, there are some helpful tips which I will discuss in the next part to try and providerelief and self-manage your heel pain and do it safely in the most cost effective manner.
Stay tuned !
Dr Vanessa Hadchiti (Podiatrist)
