Heel pain, the most common foot complaint, affects millions of people around the world and often occurs as a result of daily activities and exercise. Plantar Fasciitis is the ailment that is often associated with the symptoms of Heel Pain and Heel Spurs. Other causes which can result in a heel pain can be a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely, a cyst. Due to the fact that a heel pain can be caused due to any of the above-mentioned causes, it is vital to have heel pain properly diagnosed.

This article will concentrate on the causes of heel pain, the symptoms, as well as the most effective treatment methods available nowadays.

Plantar Fasciitis and its development:

As mentioned earlier, Plantar Fasciitis is an ailment that is often associated with the symptoms of Heel Pain and Heel Spurs. The Plantar Fascia is a flat band of fibrous ligaments located under the foot that connects the heel bone to the toes. This dense strip of tissues acts like a bow-string that spans the arch of the foot to give it support.

The Plantar Fascia generally takes the full load of the body when the foot is placed on the ground. Due the force exerted, the Plantar Fascia stretch out, flatten the foot and evenly distribute the weight of the body. Usually the Plantar Fascia is very tough and flexible to withstand forces transmitted during walking or running. However the normal function can be affected by excessive abuse of the feet, over-pronation, old age or being over-weight, because of which the Plantar Fascia exhibits micro tearing, leading to irritation, inflammation, and pain at the junction of the Plantar Fascia and calcaneus or heel bone.

The Heel Spur is a bony growth on the heel, a result of the continuous pulling of the Fascia. This growth triggers pain in the surrounding tissues that get inflamed.

Symptoms of Plantar Fasciitis

The symptoms of Plantar Fasciitis are:

 Pain on the bottom of the heel
 Pain that is usually worse upon arising
 Pain that increases over a period of months

The Plantar Fascia contracts and becomes tight while in rest periods such as sleeping or sitting. However during initial movement or when one suddenly gets up, the Fascia must quickly expand to the rapid application of the weight, thereby resulting in micro-tearing the ligaments and the pain for a few minutes.

Causes of Plantar Fasciitis

Plantar Fasciitis can result due to various factors. Some of the most common ones are:

 Faulty structure of the foot. This factor covers both individuals with overly flat feet or high-arched feet.

 Wearing non-supportive or ill-fitting footwear can also lead to this ailment.

 Strenuous, repetitive, and arduous exercises like jumping and running can be another cause for Plantar Fasciitis.

 Another major reason for Plantar Fasciitis can be obesity or pregnancy.

 Achilles tendons and tight calf muscles can also lead to Plantar Fasciitis.

Other causes for Plantar Fasciitis can be:

 Bruises on the bone.

 Excessive pronation (tendency of the foot to roll inward)

 Stress Fractures.

Diagnosis and treatment of Plantar Fasciitis

The diagnosis of Plantar Fasciitis is not easy and may involve a history of symptoms, physical examination, and other tests. With no real cure for Plantar Fasciitis, steps can be taken to prevent the pain. The Plantar Fasciitis can be treated through numerous traditional or non-surgical remedies such as:

• Ice Packs - This should be applied to the inflamed area.

• Night Splint - The mild stretching caused by night splints help in tensioning the calf muscles and Plantar Fascia.

• Shock wave therapy - Shock wave pulses applied through a special machine helps in relieving the soreness.

• Anti-inflammatory drugs - Ibuprofen drugs help in the relief of heel pain.

• Cortisone injections - The steroid treatment is locally administered in the heel area.

• Orthotic / Orthotic Insole Device - Orthotics realigns the foot and ankle-bones to their natural position and restores the normal foot function that alleviates not only foot problems but also ailments in other parts of the body.

However it is advisable to undergo long-term treatment, which have been found to be quite effective as the Plantar Fascia excessively stretches due to over-pronation (fallen arches) and tightening of the calf muscle and ligaments and the above-mentioned remedial measures assist in relieving heel pain for a short-term only.

Surgery as a means of cure should be the very last resort for the treatment of heel pain and should only be considered when all other conservative treatment has failed. In the surgical intervention the Plantar Fascia is partially released from the bone and any spur removed if found to be present. The pressure on the small nerves that traverse under the Plantar Fascia is released after proper identification of the cause.

Prevention

The state of Plantar Fasciitis is such that no matter what kind of treatment is undertaken, the primary causes that led to it may remain. Overweight being a major contributor of Plantar Fascia, steps should be taken to reach and maintain an ideal weight. Also wearing supportive shoes and using custom orthotic devices go a long way in giving relief from Plantar Fasciitis.

The fact that heel pain affects a large number of people, most people respond to conservative, non-surgical therapy and heal within 6 to 8 weeks and only a minuscule percentage of the affected population go under the knife. The American Orthopaedic Foot and Ankle Society (AOFAS) conducted a two-year national study on treatments of heel pain. The study clearly demonstrated that the best course of cost-effective treatment is a strict regime of using "off the shelf" orthotics (arch supports) and a specific stretching program. The treatment resulted in 90 percent of patients experiencing substantial relief from heel pain symptoms.