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


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.