why does my heel hurt so much

javascript is required to view the content on this page. Please enable javascript in your browser. Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation or, rarely, a cyst. Because there are several potential causes, it is important to have heel pain properly diagnosed. A foot and ankle surgeon is able to distinguish between all the possibilities and to determine the underlying source of your heel pain. What Is Plantar Fasciitis? Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain. The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fasciitis. Wearing nonsupportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when one s job requires long hours on the feet. Obesity and overuse may also contribute to plantar fasciitis. People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they have been sitting for long periods of time. After a few minutes of walking, the pain decreases because walking stretches the fascia. For some people, the pain subsides but returns after spending long periods of time on their feet. To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process, the surgeon rules out all possible causes for your heel pain other than plantar fasciitis. In addition, diagnostic imaging studies, such as x-rays or other imaging modalities, may be used to distinguish the different types of heel pain.


Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome. Treatment of plantar fasciitis begins with first-line strategies, which you can begin at home:
Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery. Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia. Ice. Putting an ice pack on your heel for 20 minutes several times a day helps reduce inflammation. Place a thin towel between the ice and your heel; do not apply ice directly to the skin. Limit activities. Cut down on extended physical activities to give your heel a rest. Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia. Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. If you still have pain after several weeks, see your foot and ankle surgeon, who may add one or more of these treatment approaches: Padding, taping and strapping. Placing pads in the shoe softens the impact of walking. Taping and strapping help support the foot and reduce strain on the fascia. Orthotic devices. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis. Injection therapy. In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain. Removable walking cast. A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal. Night splint. Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some patients.


Physical therapy. Exercises and other physical therapy measures may be used to help provide relief. When Is Surgery Needed? Although most patients with plantar fasciitis respond to nonsurgical treatment, a small percentage of patients may require surgery. If, after several months of nonsurgical treatment, you continue to have heel pain, surgery will be considered. Your foot and ankle surgeon will discuss the surgical options with you and determine which approach would be most beneficial for you. No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. Wearing supportive shoes, stretching and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis. is a foot condition in which a band of tissue in the sole of the foot becomes inflamed, leading to severe heel pain. The pain of plantar fasciitis can be so bad that it hurts to walk, much less exercise or do daily activities. But a few simple changes and precautions at home can help reduce the pain in your heels. Plantar Fasciitis Treatment: Tips at Home If heel pain is keeping you down, pamper your a bit until they're feeling better again. To relieve the pain of plantar fasciitis: Use an ice pack to reduce swelling, inflammation, and pain. Take an over-the-counter pain reliever, like ibuprofen or acetaminophen. Rest your feet by staying off of them as much as possible for a few days when your heels are aching. Some good foot flexing and stretches can help stretch out the plantar fascia, and make it feel better. You can get more information about stretching online from the. Adjust your shoes with inserts that raise the heel and support the arch of your foot. Avoid walking on uneven walking surfaces. Ice, stretching of the plantar fascia, over-the-counter arch supports, and anti-inflammatory drugs are all easy ways to relieve pain on your own, says Timothy C. Ford, DPM, director of the podiatric residency program at Jewish Hospital and St.


Mary's HealthCare in Louisville, Ky. Most often, you won't need to visit a podiatrist "unless it does not resolve in a few weeks," he says. : Other Treatments If those suggestions don't help ease heel pain, your doctor may recommend the following treatments: Wearing a special splint at night. This helps by maintaining a slight stretch of the plantar fascia while sleeping. For more serious heel pain, more aggressive measures can be taken: A shot of cortisone to reduce the inflammation. This can be effective, but tends to be painful. Extracorporeal shock wave therapy, in which external shock waves are directed to the inflamed areas of plantar fascia. Success with this procedure has been mixed, and it tends to work best with plantar fasciitis patients who are also runners. Various surgical procedures. This is usually a last-resort treatment, and only if pain is still there after many months of other treatments. Plantar Fasciitis: Prevention There are many triggers for plantar fasciitis, so it's important to learn how to reduce your risk. Being obese puts extra pressure on your feet, so is a good idea if you struggle with heel pain. The shoes you wear can also make a big difference in how your feet feel, so protect your feet and heels with shoes that offer good support in the arch and a wide, stable heel. Donвt wear worn-out shoes; replace them when there is noticeable wear on the sole. Also, donвt walk barefoot on hard surfaces. Exercise will also affect plantar fascitis. Always warm up, and never rush into a new activity в take your time, and let your muscles get used to the exercise. And invest in a pair of cushioned running shoes, which should be replaced regularly. Heel pain is certainly a bother, but don't let it stop you in your tracks. Recognize the symptoms of plantar fasciitis, and give your feet the break they deserve.

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