Why do I Have Bad Pain in my Heel?

Why do I Have Bad Pain in my Heel?

Heel pain can be caused by several conditions, such as Achilles tendonitis, arthritis, bursitis, or tarsal tunnel syndrome, for example. Heel pain may also be caused by small bone fractures in the heel. But the most common cause of heel pain is Plantar Fasciitis.

Plantar Fasciitis is a painful inflammatory condition of the foot. More specifically, Plantar Fasciitis is an inflammation of the plantar fascia, which is the ligament that connects the bottom of the heel bone to the toes. The main function of the plantar fascia is to help support the arch of the foot. Plantar Fasciitis usually develops due to intense physical activity that causes small tears and inflammation of the plantar fascia due to its overuse.

Dr. Janet Pearl

Dr. Janet Pearl – The Expert!

If you feel pain in the bottom of your heel, there is a high probability that you may have Plantar Fasciitis.

Am I at risk of having Plantar Fasciitis?

Since the main cause of Plantar Fasciitis is repetitive overload to the plantar fascia, anyone who is often in situations that places an inordinate amount of load on his/her feet is at risk of developing Plantar Fasciitis.

Runners and other athletes that pound their feet on hard surfaces are among the most likely to develop Plantar Fasciitis. Since one of the functions of the plantar fascia is to absorb the shock of your gait and stride, the repetitive impact of these types of physical activities can easily sensitize the plantar fascia to injury.

Even when there is no impact to the feet, long periods of weight bearing can put an excessive strain on the plantar fascia. The plantar fascia supports the arch of the foot, and if you stand for long periods of time, there will be a continuous high load that the ligament will have to sustain. Therefore, individuals whose jobs require standing all day are particularly vulnerable to plantar fascia injuries.

Plantar fasciitis also becomes more likely as you age simply because your tissues start to lose their elasticity and their ability to quickly recover from small injuries. This is the reason why Plantar Fasciitis often occurs between the ages of 40 and 60 years old, regardless of how physically active you are.

Being overweight also increases the risk of Plantar Fasciitis. Obviously, the more you weigh, the higher the load on your feet. Sudden weight gain is particularly stressful to your plantar fascia. Therefore, pregnant women often develop Plantar Fasciitis, particularly in the latter months of pregnancy.

Wearing improper footwear is another huge risk factor. Certain types of shoes irritate sensitive tissues in your feet, particularly the plantar fascia. If you wear shoes without proper arch support and cushioning, you inadvertently increase the strain to the plantar fascia. This is particularly problematic if you routinely stand for extended periods of time.

Plantar Fasciitis may also develop simply as a consequence of specific anatomical characteristics of the foot that increase the tension and load to which the plantar fascia is subjected. If you overpronate (excessively roll your foot inwards), if you have a high arch, or if you have tight calf muscles or a tight Achilles tendon, you are naturally predisposed to Plantar Fasciitis.

What type of pain does Plantar Fasciitis cause?

In Plantar Fasciitis, pain is usually felt in the bottom of the heel. In some instances, pain may extend along the plantar fascia into the arch of the foot. Tenderness in the heel pad and along the plantar fascia is also usually felt. Pain severity may range from slight or mild irritation to flares of severe pain.

A classic symptom of Plantar Fasciitis is severe foot pain with the first steps after a rest period, especially in the morning or after sitting for a long time. Pain usually improves when you walk for a while, but it can become worse if you stand or walk for a long time.

If you recognize these symptoms, you probably have Plantar Fasciitis. 

What should I do if I think I may have Plantar Fasciitis?

If your heel hurts and you think you may have Plantar Fasciitis, you should see a doctor right away.

The earlier you start treating Plantar Fasciitis, the better. Your plantar fascia may actually repair itself naturally with an early intervention with conservative treatment. In the majority of cases, Plantar Fasciitis may resolve within a few months with rest, stretching, ice massage, improved footwear and orthotics, night splints, and over-the-counter pain medication.

Shoe inserts are a great option for many people as well. Custom insoles can help with the alignment of the foot in a way that few other things can. Protalus sells shoe insoles for heel spur that can be a huge change in lifestyle for people suffering from this kind of pain.

On the other hand, if you ignore your pain, you risk aggravating your injury. With repeated stress, those small plantar fascia tears can accumulate and affect the strength and stability of the ligament. If left untreated, injury to the plantar fascia may progress and weaken the ligament, making it vulnerable to additional damage, degeneration and chronic inflammation. Consequently, your heel pain will only become more severe.

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• Meet the Author • Dr. Janet Pearl

Dr. Janet Pearl is a member of the American Pain Society, The Massachusetts Medical Society, the Massachusetts Society of Anesthesiologists, the Massachusetts Society of Interventional Pain Physicians and more. She received her M.D. from the Columbia College of Physicians and Surgeons and received an M. Sc. in Health Planning and Financing at the London School of Hygiene and Tropical Medicine. She is the Medical Director at the Center for Morton's Neuroma and Fasciitis.com. Follow her on LinkedIn.

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