What is it?
Heel pain is most commonly caused by plantar fasciitis, a chronic (ongoing) overuse injury of the thick band of tissue on the sole of the foot, which is known as the plantar fascia.
The heel pain of plantar fasciitis is often worst with the first few steps in the morning and can increase with standing and after exercising. The pain usually lessens with activity, but returns with inactivity.
Causes of heel pain
Biomechanical abnormalities that cause the foot to excessively pronate (roll in) on walking, tightness or weakness of the calf muscles, and abnormal functioning of the big toe, are the underlying contributors to many cases of plantar fasciitis. Sometimes painful outgrowths of bone called heel spurs form where the plantar fascia joins the heel bone, however, these are due to the pulling of the plantar fascia on the bone, and are not the primary source of the heel pain.
Treatment of heel pain
Treatment for plantar fasciitis may include rest from the aggravating activities such as walking, calf muscle stretching, applying ice, anti-inflammatory medicines and weight loss to reduce stress on the feet. Supportive footwear such as running shoes that have a stiff heel counter and a good midsole support are recommended. If necessary, foot supports, strapping or orthotics may be recommended to temporarily correct biomechanical abnormalities of the foot.
Occasionally, in severe cases, a long leg walking boot may be recommended. Other forms of treatment for resistant cases of plantar fasciitis are available and are sometimes successful. These include ESWT (extracorporeal shock wave treatment) and PRP (platelet rich plasma) injections.