Heel Pain

Heel Pain

The heel is the largest bone in the foot. Heel pain is the most common foot problem and affects 2 million Americans every year. It can occur in the front, back, or bottom of the heel. General treatment guidelines are as follows:

• The American Orthopaedic Foot and Ankle Society (AOFAS) suggests shoe inserts, medications, and stretching as a first line of therapy for heel pain. One study found that 95% of women who used an insert and did simple stretching exercises for the Achilles tendon and plantar fascia experienced improvement after 8 weeks.
• If these treatments fail, the patient may need prescription heel orthotics and extended physical therapy.
• Heel surgery to relieve pain may be performed for heel spurs, plantar fasciitis, bursitis, or neuroma.
• Surgery is not recommended until nonsurgical methods have failed for at least 6 months and preferably up to 12 months. Nonsurgical treatments for heel pain are effective in 90% of patients.

Plantar Fasciitis and Heel Spur Syndrome

Plantar Fasciitis and Heel Spurs. Plantar fasciitis is a common foot problem that accounts for 1 million office visits per year. Plantar fasciitis occurs from small tears and inflammation in the wide band of tendons and ligaments that stretches from the heel to the ball of the foot. This band, much like the tensed string in a bow, forms the arch of the foot and helps to serve as a shock absorber for the body. The term plantar means the sole of the foot, and fascia refers to any fibrous connective tissue in the body. Most people with plantar fasciitis experience pain in the heel with their first steps in the morning. The pain also often spreads to the arch. The condition can be temporary or may become chronic if the problem is ignored. In such cases, resting provides relief, but only temporarily.

Heel spurs are calcium deposits that can develop under the heel bone as result of the inflammation that occurs with plantar fasciitis. Heel spurs and plantar fasciitis are sometimes blamed interchangeably for pain, but plantar fasciitis can occur without heel spurs, and spurs commonly develop without causing any symptoms at all.