Plantar fasciitis is the most common cause of heel pain. The exact cause of plantar fasciitis is unclear it is thought to be a degeneration of the plantar fascia. The Plantar fascia is a thick ligamentous band on the sole of the foot that supports your arch and helps to absorb shocks when walking or running. It attaches to the calcaneus or heel bone. The risk of developing heel pain increases with increased activity, age and being overweight.
Causes of heel pain can also include Achillis Tendinopathy, Retrocalcaneal Bursitis, Tibialis Posterior Tendinopathy, Flexor Hallucis Longus Tendinopathy, Stress Fractures, Nerve Entrapment and Severs disease in young people.
Plantar fasciitis typically presents with pain under the heel, which is worse first thing in the morning and after periods of rest. It can ease out as the day goes on and get worse after prolonged standing/activity. Plantar fasciitis can become chronic and last months if left untreated.
Plantar fasciitis is typically a diagnosis made by the doctor after a history and examination. X-rays are usually unhelpful and may reveal a “Heel Spur” (a bony protrusion at the heel bone) which is of no clinical significance. Occasionally a MRI may be ordered to confirm the diagnosis or to out rule other causes of heel pain.
Treatment can include Extracorporeal Shock Wave Therapy ESWT to help relieve pain, stretching and strengthening exercises. A period of immobilization, splints or orthotics/gel heel pads may offer relief. Steroid injections are generally not recommended for the treatment of plantar fasciitis.