Heel pain is the most common problem that brings people to a foot doctor's office. While many conditions can cause foot pain, there are two that occur most frequently: Plantar Fasciitis (fah shy tis) Posterior Heel Pain Plantar Fasciitis Do you wake up in the morning and dread the thought of putting your foot on the floor because you know your heel will be painful? • Do you dread standing up after sitting for a while? • Does this pain tend to ease as you start to walk around? • Does your heel hurt more as the day progresses? • Do you have more heel pain the day after you have been more active? If you answered yes to some or all of these questions, you may have plantar fasciitis. The plantar fascia is a thick band of supportive tissue that begins on the bottom of the heel and runs toward the toes. This fibrous band helps to stabilize and support your foot when you are standing, walking or running. Why does the plantar fascia become painful? Pain develops when the fibers of the fascia become stretched or develop small tears. This occurs for many reasons. Examples include: Increasing activity levels too fast. For instance, beginning a new running or walking program, but doing too much too soon and not gradually increasing the distances run or walked. Wearing shoes that are not supportive enough. Wearing worn out shoes to exercise or when working in your yard. Plantar Fasciitis Treatment Treating plantar fasciitis in the early stages usually allows for a quicker recovery. Left untreated, this condition can progress to the point where there is pain with each and every step. This typically means a return to a pain free day will take much longer. Initial treatments are aimed at reducing stress on the fascia so it can begin to heal. Also, treatment to reduce the associated inflammation is started. These treatments often include: ice therapy, anti-inflammatory medications, stretching exercises, wearing shoes with appropriate support, taping of the foot and the use of a night splint. If these interventions do not lead to a full resolution, custom shoe inserts, cortisone injections and additional treatment by a physical therapist are often utilized. For patients that fail to respond to all of these efforts, surgical release of the plantar fascia can be a very effective course of action. The good news is this: 95% of the time plantar fasciitis can be fully resolved without the need for surgery. High energy shock wave therapy, sometimes referred to as orthotripsy, is a relatively new treatment that has been shown to be effective 70% of the time in patients that continue to have pain despite extensive non-surgical treatment.
