Heel Pain due to Plantar Fasciitis is a common issue of concern among many individuals. One may typically experience intense pain when taking the first step out of the bed which gets better after sometime. However, the pain may return after walking or standing for long. The pain may also radiate along the entire sole of foot and it may be stabbing in nature. The underlying pathology is due to inflammation or micro tear of a band of tissue (plantar fascia) that connects the bottom of the heel to the toes.
The risk factors in developing Plantar Fasciitis must be identified. It is often due to a high arch in the feet or due to flat feet. It may also be associated with a tight Achilles Tendon. The inflammation may be triggered by repeated stress of the plantar fascia due to daily activities. Therefore, if the pain is severe and persistent, a holistic evaluation of the foot and the lower limbs together with a detailed history is all that is required to identify possible risk factors of concern. An Xray may suggest a heel spur which may indicate chronicity of the issue of concern.
The treatment in the acute phase may consist of anti – inflammatory medications, icing and resting the foot. In very severe cases if pain is unbearable and it is not responding to conservative methods, then a steroid injection may be an option to consider. However, it is crucial to understand the underlying issue of concern and to adopt a holistic approach to management so that the pathology is cured and does not reoccur.
There are several remedies to comply with that can effectively manage the issue of concern. Regular and consistent foot exercises to strengthen the arch supporting muscles, calf muscles and to stretch out the tight Achilles tendon is very important. The stretches should also be done before taking the first step after a prolonged period of immobility for example after getting up from sleep or sitting for long periods. Besides that, other modalities of physiotherapy such as tapping, manual plantar fascia release and ice treatment would be helpful in the acute phase. Modification of lifestyle and sports activities is again very important to minimise the stress on the plantar fascia and to allow the inflammation to heal completely. Appropriate foot wear with insoles/arch supports are very helpful in off-loading the stress on the plantar fascia along with weight reduction.
Heel pain due to plantar fasciitis can be troubling to an individual as it limits function. Although the pain can be effectively managed with medications, a holistic approach to address all risk factors is of paramount importance to reduce the rate of recurrence. A complete resolution of the inflammation may take months and hence it will certainly require an adaptation in lifestyle along with modification of activities. Take the first step of preventing plantar fasciitis for pain free steps in the future. With compliance and perseverance, you can Heal your HEEL!
Dr Hitendra K Doshi
Orthopaedic and Trauma Surgeon
HK Doshi Orthopaedic Center
www.hkdortho.com
HK Doshi Orthopaedic U Tube Channel
www.youtube.com/c/HKDoshiOrthopaedicCenter/videos
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