Ask a Doc: This could be why your heel is hurting
Dr. Sana’s latest article in www.azcentral.com about plantar fasciitis, symptoms, causes, diagnostic tests, home treatments, and medical treatments.
Question: What is causing my heel to hurt?
Answer: While a diagnosis would have to come after a doctor’s examination, it could be plantar fasciitis, which is a foot condition that most commonly occurs in people between 40 and 60 years of age. Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. It supports the arch of your foot and helps you walk.
Plantar fasciitis is one of the most common foot complaints. Too much pressure on your feet can damage or tear the ligaments. The plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness.
Symptoms
- Pain on the bottom of the heel (described as dull, achy or sharp).
- Pain in the arch of the foot.
- Pain that is usually worse upon arising or getting up in the morning.
- Swelling on the bottom of the heel.
Causes
- Sudden gain in weight or obesity.
- Pregnancy, particularly late in pregnancy due to ligaments becoming more relaxed.
- Walking barefoot on hard surfaces.
- Flatfoot or high arch.
- Tight Achilles tendon.
- Over-use injury (new or increase in physical activity).
- Standing on your feet for prolonged period of time or lifting heavy objects.
- The normal aging process, which can result in a loss of soft tissue elasticity.
- Tight calf muscles.
- Poor shoe gear (soft soles or no arch support).
- Arthritis or diabetes.
Diagnostic tests
- Physical exam.
- Biomechanical exam.
- X-ray of heel.
- Ultrasound.
- MRI.
Home treatments
- Staying off feet and applying ice 15 to 20 minutes, couple times a day.
- Reducing or changing your exercise activities.
- Using arch support (custom orthotics).
- Home stretching exercises.
Medical treatments
- Cortisone injections.
- Taping of foot.
- Nonsteroidal anti-inflammatory medication (NSAIDs). Drugs such as ibuprofen or naproxen reduce pain and inflammation. Using the medication for more than 1 month should be reviewed with your primary care doctor.
- Stretching exercises (plantar fascia and calf stretching).
- Custom orthotics.
- Night splint.
- Physical therapy.
- Surgery (if conservative therapies fail).