Heel pain (plantar fasciitis)

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What is heel pain (plantar fasciitis)?

The normal cause of heel pain is damage to the plantar fascia, the band of tissue in the foot. Typically, the pain intensifies over time, and with only one heel being affected. Many sufferers report feeling greater pain on rising in the morning, or after rest.

What causes heel pain?

The primary reason for heel pain is damage to the plantar fascia, the tough, flexible tissue running beneath the sole of the foot, which links the heel bone to the foot’s bones and functions like a shock absorber.

Tiny tears inside the tissue form part of this damage; these tears make the tissue thicken, which triggers the pain. General wear and tear, notably osteoarthritis in the sub-talar joint, and heel bone stress fractures (calcaneus), are other causes of heel pain.

Heel pain is more likely for those who:

  • Are between 40-60 years old
  • Have weight problems
  • Are employed in a job where they are on their feet for long periods
  • Wear flat shoes
  • Walk or run on hard surfaces for long distances
  • Have limited ankle joint movement or shortened calf and hamstring length

What are the symptoms of heel pain?

Increasing pain over time and inflammation of the tissue around the plantar fascia.

How is heel pain diagnosed?

At your initial appointment, you will have the chance to talk through your symptoms with your consultant, who will outline your treatment options. Heel pain can be normally be diagnosed without the need for further diagnostic testing, but X-rays, an MRI scan or an ultrasound scan are sometimes necessary.

How is heel pain treated?

It can be that your heel pain will dissipate without treatment, provided that you rest your heel and follow some simple stretching exercises, together with wearing supportive shoes, like running shoes for example, to cushion your feet.

Should the pain continue to trouble you, the application of an ice pack may soothe the symptoms. Anti-inflammatory painkillers may help, and a course of physiotherapy may be recommended too.

Some heel pain sufferers have noticed that wearing splints overnight can reduce the pain. Complete recovery from plantar fasciitis typically takes between 12-18 months, but if your symptoms persist, your consultant may propose surgery to release your Achilles tendon.