There are many underlying causes of heel pain, and some physicians feel that it is probably more accurate to simply make a diagnosis of heel pain rather than try and define an absolute cause in every instance.
Plantar fasciitis occurs in both men and women, but is more common in women.
Women have a significantly higher incidence of heel spurs due to certain types of footwear that are worn on a regular basis.
Plantar fasciitis, the most common cause of heel pain, may have several different clinical presentations. Although pain may occur along the entire course of the plantar fascia, it is usually described as pain in the heel that occurs when taking the first few steps in the morning, with the symptoms lessening as walking continues. The pain is localized to an area that the examiner identifies as the medial calcaneal tubercle near the inside of the foot where the heel and arch meet. This bony prominence serves as the point of origin of the anatomic central band of the plantar fascia and three muscles between the heel and forefoot. The pain is located here since the weakest point of the plantar fascia is at its origin on this tubercle.
The pain is usually insidious, with no history of acute trauma. Many patients state that they believe the condition to be the result of a stone bruise or a recent increase in daily activity. It is not unusual for a patient to endure the symptoms and try to relieve them with home remedies for many years before seeking medical treatment.
Plantar fasciitis is often referred to as "heel spur syndrome" in the literature and the medical community, but the label is a misnomer. This vague and nonspecific term incorrectly suggests that bony "spurs" are the cause of pain rather than an incidental X-ray finding. There is usually no correlation between pain and the presence or absence of bony growths and excision of a spur is not part of the usual surgery for plantar fasciitis.
The key for the proper treatment of plantar fasciitis is determining what is causing the excessive stretching of the plantar fascia. Common treatments include stretching exercises, plantar fasciitis night splints, wearing shoes that have a cushioned heel to absorb shock, and elevating the heel with the use of a heel cradle or heel cup. Heel cradles and heel cups provide extra comfort, cushion the heel, and reduce the amount of shock and shear forces placed during everyday activities.
Every time your foot strikes the ground, the plantar fascia is stretched. You can reduce the strain and stress on the plantar fascia by following these simple instructions: Avoid running on hard or uneven ground, lose any excess weight, and wear shoes and orthotics that support your arch to prevent over-stretching of the plantar fascia.
Cortisone injections should be avoided in the initial treatment of plantar fasciitis; they should be suggested only as supplemental treatment in patients who have resistant chronic plantar fasciitis after achieving adequate biomechanical control. These injections may provide only temporary relief and can cause a loss of the plantar fat pad if used injudiciously.
When the cause is flat feet, an orthotic support with rear-foot posting and longitudinal arch is effective in reducing the over-pronation and allows the condition to heal. See your podiatrist to have an arch support fitted.
If you have usually high arches, which can also lead to plantar fasciitis, cushion the heel and use shock-absorbing footwear.
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