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The plantar fascia is a thick band of fibrous connective tissue that connects the heel to the ball of the foot and the base of the toes. Heel pain also manifests with a traumatic fracture, a stress fracture, a bone tumor, a bone bruise, Achilles tendon related bursitis, neuritis, and Sever’s apophysitis (irritation of the growth plate seen in children). Pain is usually worse in the morning after getting out of bed and after periods of non weight bearing such as after a drive or after being seated for a while. Patients should be aware that the condition can linger for many months even after implementing a treatment program.

History, physical exam, radiographs, and sometimes an MRI will determine the cause of the pain. Treatment may include oral medication, injection therapy, ice, particular stretching exercises, physical therapy, strapping, night splints, arch supports or custom orthotics, modifying shoes, and rest from certain activities. Should these modalities fail to provide complete relief other treatments can be considered such as extra corporeal shock wave therapy (ECSWT), PRP injection therapy (PRP), radiofrequency lesioning, cryotherapy, and surgery. When the plantar fascia is strained it can repeatedly tear away the lining or tissue that covers the heel bone resulting in a spur.

It is important to understand that individuals with heel spurs may never develop plantar fasciitis or heel pain, and individuals suffering from plantar fasciitis may never develop a heel spur.
The presence of a spur does not commonly change the treatment as it is not the primary cause of pain.

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Comments to “Treatment heel pain”

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