Heel pain: plantar fasciitis, the symptoms, causes and treatments

Heel pain is irritating, uncomfortable and well, quite frankly, a pain. Walking, running and enjoying the activities you love most becomes difficult – we understand your frustration!

Heel pain is the most common problem we see in our podiatry clinic – Epsom Footcare – and in most cases it is caused by small repetitive mechanical injuries that have developed at a faster rate than your body can heal them. We call this mechanical overload. However, there can be other causes of heel pain, such as lower back problems or inflammatory joint conditions. In this article we are going to explore one of the most common causes of heel pain, plantar fasciitis. We’ll explain what it is, what causes it and the actions you can take if you believe you may have this aggravating condition.

What is plantar fasciitis?

Plantar fasciitis is an injury to a tissue at the bottom of your heel and foot called the plantar fascia.  Your plantar fascia is a thick connective tissue band that originates from your heel and then spans across your foot like a fan to connect to all five toes. This helps to promote the function of your foot and maintain its shape, strength and flexibility. When your fascia has been overloaded it can become painful. “Itis” in medical terms means inflammation but with the condition we are describing there is rarely any inflammation present. As a result, we prefer to call it plantar fasciopathy.

What are the symptoms of plantar fasciopathy?

Symptoms of plantar fasciopathy can vary but the most common symptom is heel pain first thing in the morning that tends to ease after a few minutes of walking. Other symptoms you may experience include:

• Pain at the bottom of the heel that radiates into your arch
• Pain on standing after you have been resting
• Pain may come and go, or be constantly present, but often eases a few minutes after you start walking around
• Pain can range from mild discomfort to an intense stabbing pain
• Swelling

These symptoms can also relate to other conditions so if you have ongoing heel pain we recommend seeing a podiatrist to make sure you get the correct diagnosis.

What causes plantar fasciopathy?

Plantar fasciopathy is caused by overload which causes changes in the fibres of the tissue that occur more quickly than the normal tissue healing response can cope with. The opposite can also occur where something is happening to reduce the body’s ability to heal. This can lead to the same problem under normal loading conditions.

Typical causes are:

• A sudden increase in the volume or intensity of physical activity
• Unusual that strain the arch of your foot
• An increase in bodyweight (especially rapid increases such as in pregnancy)
• Wearing shoes that you don’t normally wear
• Faulty training techniques when exercising
• Increasing age
• Hormonal changes

It can be a combination of causes that have ultimately created the overload and correcting these is fundamental to resolving your heel pain and in helping to prevent heel pain from being an ongoing problem for you in the future.

What can you do to reduce your heel pain?

If you experience heel pain and feel you may have plantar fasciopathy, there are a few simple actions you can try such as:

• Avoiding wearing uncomfortable shoes, or shoes that do not fit correctly – shoes which are comfortable and supportive are a good place to start
• Reducing the volume and/or intensity of the exercise that you are doing (at least temporarily) to allow the irritable tissues to recover –
• Resting regularly and trying not to walk or run too fast
• Wear shoes with a slightly elevated heel
• Visit a podiatrist

How can a podiatrist help with your heel pain?

Visiting a podiatrist, like our team of specialists at Epsom Footcare, is beneficial when you are struggling with heel pain as we can complete a full assessment to establish the cause and the correct diagnosis as well as put together a treatment plan fully tailored to your needs.

There are a number of potential treatments and recommendations your podiatrist may make following your initial consultation. They may suggest changes to your footwear, specially chosen stretching exercises, padding or strapping techniques, steroid injections, shockwave therapy, mechanical assessment of your foot function with a view to or longer-term interventions such as orthotic insoles. With an initial consultation we will find the best ways to work with you to find the most effective outcome.

If you are struggling with heel pain, or feel you may have plantar fasciopathy, book your initial consultation and get back on track to living pain free. Call our team on 01372 723000 or book online.