What Exactly Causes Pain Under The Heel

Plantar Fasciitis

Overview

Plantar fasciitis is a condition characterised by damage and inflammation to the plantar fascia (i.e. the connective tissue on the sole of the foot forming the inner arch. This usually occurs at the attachment of the plantar fascia to the heel bone. Plantar fasciitis is the most common cause of heel pain seen in clinical practice. During walking or running, tension is placed through the plantar fascia. When this tension is excessive (often due to poor foot biomechanics such as flat feet or if it is too repetitive or forceful, damage to the plantar fascia can occur. Plantar fasciitis is a condition where there is damage to the plantar fascia with subsequent inflammation and degeneration. This may occur traumatically due to a high force going through the plantar fascia beyond what it can withstand or, more commonly, due to gradual wear and tear associated with overuse. Occasionally, a heel spur may develop in association with plantar fasciitis.




Causes

Plantar fasciitis is caused by drastic or sudden increases in mileage, poor foot structure, and inappropriate running shoes, which can overload the plantar fascia, the connective tissue that runs from the heel to the base of the toes. The plantar fascia may look like a series of fat rubber bands, but it's made of collagen, a rigid protein that's not very stretchy. The stress of overuse, overpronation, or overused shoes can rip tiny tears in it, causing pain and inflammation, a.k.a. plantar fasciitis.




Symptoms

Plantar fasciitis has a few possible symptoms. The symptoms can occur suddenly or gradually. Not all of the symptoms must be present at once. The classic symptom of plantar fasciitis is pain around the heel with the first few steps out of bed or after resting for a considerable period of time. This pain fades away a few minutes after the feet warm up. This symptom is so common that it symbols the plantar fasciitis disorder. If you have it then probably you have plantar fasciitis. If you don’t suffer from morning pain then you might want to reconsider your diagnosis. Pain below the heel bone at the connection of the bone to the fascia. As the condition becomes more severe the pain can get more intense during the day without rest. Plantar fasciitis symptoms include pain while touching the inside of the heel or along the arch. Foot pain after you spend long periods of time standing on your feet. Pain when stretching the plantar fascia. Foot pain that worsens when climbing stairs or standing on the toes. Pain that feels as though you are walking on glass. Pain when you start to exercise that gets better as you warm up but returns after you stop.




Diagnosis

Your doctor will perform a physical exam to check for tenderness in your foot and the exact location of the pain to make sure that it’s not caused by a different foot problem. The doctor may ask you to flex your foot while he or she pushes on the plantar fascia to see if the pain gets worse as you flex and better as you point your toe. Mild redness or swelling will also be noted. Your doctor will evaluate the strength of your muscles and the health of your nerves by checking your reflexes, your muscle tone, your sense of touch and sight, your coordination, and your balance. X-rays or a magnetic resonance imaging (MRI) scan may be ordered to check that nothing else is causing your heel pain, such as a bone fracture.




Non Surgical Treatment

Although there is no single cure, many treatments can be used to ease pain. In order to treat it effectively for the long-term, the cause of the condition must be corrected as well as treating the symptoms. Rest until it is not painful. It can be very difficult to rest the foot as most people will be on their feet during the day for work. A plantar fasciitis taping technique can help support the foot relieving pain and helping it rest. Plantar fasciitis tapingApply ice or cold therapy to help reduce pain and inflammation. Cold therapy can be applied for 10 minutes every hour if the injury is particularly painful for the first 24 to 48 hours. This can be reduced to 3 times a day as symptoms ease. Plantar fasciitis exercises can be done if pain allows, in particular stretching the fascia is an important part of treatment and prevention. Simply reducing pain and inflammation alone is unlikely to result in long term recovery. The fascia tightens up making the origin at the heel more susceptible to stress. Plantar fasciitis night splint. Plantar fasciitis night splint is an excellent product which is worn overnight and gently stretches the calf muscles preventing it from tightening up overnight.

Plantar Fascitis




Surgical Treatment

In unusual cases, surgical intervention is necessary for relief of pain. These should only be employed after non-surgical efforts have been used without relief. Generally, such surgical procedures may be completed on an outpatient basis in less than one hour, using local anesthesia or minimal sedation administrated by a trained anesthesiologist. In such cases, the surgeon may remove or release the injured and inflamed fascia, after a small incision is made in the heel. A surgical procedure may also be undertaken to remove bone spurs, sometimes as part of the same surgery addressing the damaged tissue. A cast may be used to immobilize the foot following surgery and crutches provided in order to allow greater mobility while keeping weight off the recovering foot during healing. After removal of the cast, several weeks of physical therapy can be used to speed recovery, reduce swelling and restore flexibility.




Prevention

While there are no sure ways to prevent plantar fasciitis, these prevention tips may be helpful. Keep your weight under reasonable control. Wear comfortable, supportive shoes. Use care when starting or intensifying exercise programmes.

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