Probably the most common is plantar fasciitis
, an inflammation
of the plantar fascia (a ligament that connects your heel bone on the bottom of your foot to your metatarsal heads by the ball of your foot), and plantar fasciitis is characterized by something called post-static dyskinesia
, or in simple terms, pain after rest. The first step getting out of bed in the morning is the killer, and then it seems to ease up as you walk, but if you sit for a while, take a long car ride, etc., then get up, it starts all over again.
Other causes of heel pain are stress
fractures of the heel bone or a fractured heel spur, tarsal tunnel syndrome
(like carpal tunnel, but in the ankle), nerve
compression and entrapment, neuromas, loss of fat pad protection, and referred pain from the low back called â€œradiculopathy.â€ some collagen
vascular disorders, like rheumatoid arthritis
, ankylosing spondylitis
, lupus and reiterâ€™s disease can all produce heel pain, as well as bone and soft tissue tumors.
The diagnosis is made by clinical examination and x-rays. Sometimes, an MRI or nerve conduction tests are also needed. The treatment for heel pain varies widely, and some treatment for one cause of heel pain can make a different cause of heel pain much worse. For instance, a steroid injection has a dramatic effect on alleviating pain from plantar fasciitis, but if there is a stress fracture present, a steroid injection could prevent the fracture from healing. The single most important thing in dealing with heel pain is an accurate diagnosis.
Many people with heel pain are told they have heel â€œspurs.â€ a heel spur is a small lip of bone that is formed from years of pulling from the plantar fascia. We now know heel spurs are not a source of pain. Millions of people have heel spurs and are unaware of it. Conversely, it is common to treat plantar fasciitis and become completely pain-free without ever addressing the actual spur.
Treatment for plantar fasciitis can involve anti-inflammatory medication, stretching exercises, orthotics, physical therapy
and steroid injections. Some patients find impressive relief from acupuncture too. A recent study showed that a night splint
(to keep your foot at a 90 degree angle to the leg) while you sleep
is one of the single most effective treatments for plantar fasciitis.
Your first step in dealing with heel pain should be an accurate diagnosis, so a visit to a podiatrist or orthopedic surgeon is the best starting place.