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Heel pain is a common occurrence in many adults. In fact, it is considered as the most widespread form of foot problem that results from everyday physical activities, since the heel bone or calcaneus –the largest bone in the foot– is the one that sets on the ground first during walking.

If you are experiencing trouble walking, or have been feeling pain in your heels, this in-depth examination of heel pain and its causes, symptoms and treatment will serve as a useful guide.

Plantar Fasciitis

Heel pain can be caused by many factors, but the most common is plantar fasciitis. This term refers to inflammation of the plantar fascia or the arch tendon of the foot, which is the thick broad tissue running from under the heel to the front of the foot.

This type of injury is a typical result of foot overuse, such as when a person undergoes very strenuous physical activity or manual labor that involves the use of the feet (i.e. long periods standing,  excessive running, walking or climbing). Plantar fasciitis is often misconstrued as heel spur syndrome, however heel spurs are a different condition altogether, as explained below.

More often than not, plantar fasciitis results from biomechanical imbalance that causes abnormal pronation. For instance, there is a case where the patient appears to have a flexible rear foot varus and a normal foot structure. However, when bearing a heavy weight on a continuous basis, the pronation becomes significantly different. This kind of pronation may increase tension on the plantar fascia, and can lead to plantar fasciitis.

Symptoms

• Morning pain People who are diagnosed with this type of injury usually talk about feeling pain during the first steps they walk in the morning. The pain may gradually decreases as the walking continues.
• Pain under and inside the heel This pain originates from the attachment of the fascia.
• Pain on the border of the heel This is a result of unbalanced weight on one side of the foot, which is usually caused by intense physical sports such as tennis, football or basketball.

Treatment

Treating Plantar Fasciitis depends largely on the cause for the condition, so it is best to determine first what exactly is causing your pain before you undergo any treatment. Seeking medical advice is recommended, but you can first treat your heel pain with the following basic treatment methods:

• Wear orthotic shoe inserts that prevent abnormal pronation and provide efficient arch support. These devices help release the tension in the Plantar Fascia, gives relief to pain and contributes to comfortable walking.
• Rest. Take regular breaks and avoid prolonged strenuous activities as much as possible. Walking on an injured foot only makes the injury and inflammation worse, so be sure to give yourself a rest.
• Cold therapy. Applying ice on your foot decreases pain and inflammation. Do this for at least 5 minutes each night on the plantar area of the heel.
• Stretching. Flex your feet while you sit and before you go to bed to prevent tightening of muscles in the morning.

Sciatica

Sciatica is typically caused by the compression of lumbar nerves L4 of L5, sacral nerves S1, S2 or S3 or the sciatic nerve itself. Heel pain caused by sciatica is a result of pressure on the L5-S1 nerve root, which is responsible for the segmental innervations to some leg muscles, the sensation of the heel and the ankle reflex.

Symptoms

• Pain that stretches from the back to the buttocks to the legs and feet
• Numbness, muscle weakness in the legs and feet
• Tingling sensation or “pins and needles” on the feet
• Treatment
• Acupuncture
• Anti-inflammatory medications such as oral steroids
• Chiropractic
• Osteopathy
• Pain medication such as acetaminophen
• Physical therapy
• Stretching exercises

Heel Spurs

A heel spur, a common occurrence in women who wear high-heeled shoes, is a bony growth on the heel bone (calcaneus), the part where the plantar fascia attaches to the heel. As mentioned earlier, many people confuse this term with plantar fasciitis. However, even though they are related (plantar fasciitis often leads to a heel spur), they are not the same.
Heel spurs are more common in people who have abnormal pronation of the foot due to flat feet, who endure long walking, who are overweight and who have tight calf muscles.

Symptoms

• Dull pain that becomes sharper and more intense over time
  Intense pain in the morning or after a long period of rest that occur in the mid- or fore-foot
• Visible swelling may appear in severe heel spur cases
  Treatment
• Wearing of orthotic insoles These devices correct abnormal foot mechanics, provide arch support, and release tension.
• Apply ice to relieve pain and reduce inflammation.

Tarsal Tunnel Syndrome

The tarsal tunnel, which is the narrow space found on the inside of the ankle, is covered with a thick ligament called the flexor retinacuulum that maintains the structures within the tunnel. One of the structures found in this tunnel is the posterior tibial nerve. When this nerve is compressed or squeezed, tarsal tunnel syndrome occurs.

Symptoms

• Tingling and burning sensation
• Numbness of feet
• Shooting pain inside the ankle or on the bottom of the foot

Treatment

• Rest - Avoid walking on the injured foot so as not to worsen injury and to encourage healing.
• Apply ice Reduce the swelling by applying ice over the affected area 20 minutes for each hour you walk. 
• Oral medications such as non-steroidal anti-inflammatory drugs.
• Immobilization of the injured foot through a cast
• Physical therapy
• Orthotic devices such as shoe inserts to limit excessive motion that can lead to compression on the nerve.
• Surgery. An orthopedic surgeon will determine if surgery is the necessary recourse to your specific condition.

Our feet are often some of the most neglected parts of our body. However, thinking how important foot health is to our overall well-being, it is necessary that we take proper care of them.

Tags: plantar fasciitis | heel spurs | heel spurs | heel pain | foot pain | foot pain | foot care | foot care

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This entry was posted on Thursday, October 23rd, 2008 at 12:49 pm and is filed under Natural health. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.