Podiatric Physician & Surgeon

2655 Siskiyou Blvd.
Medford, OR 97504
(541)-773-3338


 

Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely, a cyst. Because there are several potential causes, it is important to have heel pain properly diagnosed. A podiatric foot and ankle surgeon is best trained to distinguish between all the possibilities and determine the underlying source of your heel pain.

What Is Plantar Fasciitis?
Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed resulting in heel pain.

The symptoms of plantar fasciitis are:

  • Pain on the bottom of the heel
  • Pain that is usually worse upon arising in the morning or after periods of rest.
  • Pain that increases over a period of months.

People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they've been sitting for long periods of time. After a few minutes of walking the pain decreases, because walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.

Causes of Plantar Fasciitis
Plantar fasciitis is caused by a number of different factors resulting in longitudinal stretch on the fascia. The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches either overly flat feet or high-arched feet, are more prone to developing plantar fasciitis. Wearing non-supportive footwear puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. Obesity also contributes to plantar fasciitis.

Diagnosis
To arrive at a diagnosis, the podiatric foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays, diagnostic ultrasound, or magnetic resonance imaging (MRI) may be used to distinguish the different types of heel pain. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.

Treatment Options
Treatment of plantar fasciitis begins with first-line strategies, which you can begin at home:

  • Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery.
  • Injection therapy. In some cases, cortisone injections are used to help reduce the inflammation and relieve pain.$ Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia.
  • Ice. Putting an ice pack on your heel for 20 minutes in the evening helps reduce inflammation.
  • Limit activities. Cut down on extended physical activities to give your heel a rest.
  • Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia. Your shoes should provide a comfortable environment for the foot.
  • Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful as an adjunct to other approaches and may help reduce pain and inflammation.
  • Lose weight. Extra pounds put extra stress on your plantar fascia.
  • Orthotic devices. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis.
  • Endoscopic plantar fascial release. Endoscopic plantar fascial release is a minor procedure performed to release stress on the fascia. Minimally invasive, this procedure is highly successful in solving this problem and recovery time is short -patients are usually back to normal shoe wear in one weeks time.

Long-term Care
No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. If you are overweight, it is important to reach and maintain an ideal weight. For all patients, wearing supportive shoes and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.