Introduction:
Heel pain is caused most commonly by plantar fasciitis.
The other causes of heel pain are:
- Hairline fracture of the heel bone in joggers and hikers
- Bone growth on the back of heel-haglund deformity.
- And, rarely heel pad necrosis.
Cause of heel pain or plantar fasciitis:
One has to know the function of plantar fascia to understand why plantar fasciitis occurs.
- Plantar fascia is a thick sheath under the skin of the foot
- It allows the foot to grip and allow the foot to participate in walking, running etc.
Inflammation of the fascia at the bone attachment is the
cause of pain.
- Essentially there is less blood supply at the attachment of the fascia on the bone.
- Inflammation
can become chronic.
Symptoms of heel pain:
- Early morning pain and stiffness.
- Pain after a period of rest.
- Pain on standing or walking.
- It may be associated with other joint pain.
How to go about Plantar fascia diagnosis:
- Your orthpaedician doctor’s clinical judgement is best.
- An x ray is done to find other causes of heel pain. X ray may show a heel spur which
indicates duration of disease. - MRI is done to note tendon inflammation on the back of heel.
x ray of a bone spur in a long-standing case of plantar fasciitis.
What is the treatment of plantar fasciitis:
- Anti-inflammatory tablets
- Soft insoles or insole lined footwear
- Toe curl exercises and physiotherapy
- Wearing a night splint to keep the leg in a relaxed position to minimize early morning pain.
- Injection of anti-inflammatory
- Anti-inflammatory injection works very well.
- Duration of action can vary from few weeks to a year.
- It can be repeated up-to a maximum of three in a year.
Above: Night splint-gives good morning relief
Anti-inflammatory injection
Surgery for plantar fasciitis:
What other treatments are available for plantar fasciitis:
- PRP (platlet rich plasma) is also quite effective.
- Patient’s own blood is drawn and spun in a centrifuge to separate the various components.
- The component having growth factors is injected in a sterile area like operating
theatre with local anesthesia. - RF (Radio frequency co-ablator) is a technique that destroys the pain producing area.
- Surgery for plantar fascia release.
Surgery for plantar fasciitis:
- Done in cases where there has been no response to the above treatment.
- The fascia pulling on the bone is released partially
- Patient can walk in a day or two.
- Patient recovery is good.