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1. HEEL PAIN
H eel pain is most often caused
by plantar fasciitis—a condition
that is sometimes also called heel spur
spending long periods of time on
their feet.
In addition, diagnostic imaging
studies such as x-rays, a bone scan, or
magnetic resonance imaging (MRI)
syndrome when a spur is present. may be used to distinguish the differ-
Heel pain may also be due to other ent types of heel pain. Sometimes
causes, such as a stress fracture, heel spurs are found in patients with
tendonitis, arthritis, nerve irritation, plantar fasciitis, but these are rarely a
or, rarely, a cyst. source of pain. When they are present,
Because there are several potential the condition may be diagnosed as
causes, it is important to have heel plantar fasciitis/heel spur syndrome.
pain properly diagnosed. A podiatric
foot and ankle surgeon is best Treatment Options
trained to distinguish between all Causes of Plantar Fasciitis Treatment of plantar fasciitis begins
the possibilities and determine the The most common cause of plantar with first-line strategies, which you
underlying source of your heel pain. fasciitis relates to faulty structure of can begin at home:
the foot. For example, people who • Stretching exercises. Exercises that
What Is Plantar Fasciitis? have problems with their arches— stretch out the calf muscles help
Plantar fasciitis is an inflammation either overly flat feet or high-arched ease pain and assist with recovery.
of the band of tissue (the plantar feet—are more prone to developing • Avoid going barefoot. When you
fascia) that extends from the heel to plantar fasciitis. walk without shoes, you put
the toes. In this condition, the fascia Wearing non-supportive footwear undue strain and stress on your
first becomes irritated and then on hard, flat surfaces puts abnormal plantar fascia.
inflamed—resulting in heel pain. strain on the plantar fascia and • Ice. Putting an ice pack on your
The symptoms of plantar fasciitis are: can also lead to plantar fasciitis. heel for 10 minutes several times
• Pain on the bottom of the heel This is particularly evident when a a day helps reduce inflammation.
• Pain that is usually worse upon person’s job requires long hours on • Limit activities. Cut down on
arising their feet. Obesity also contributes extended physical activities to
• Pain that increases over a period to plantar fasciitis. give your heel a rest.
of months • Shoe modifications. Wearing
People with plantar fasciitis often Diagnosis supportive shoes that have good
describe the pain as worse when To arrive at a diagnosis, the podiatric arch support and a slightly raised
they get up in the morning or after foot and ankle surgeon will obtain heel reduces stress on the plantar
they’ve been sitting for long periods of your medical history and examine fascia. Your shoes should provide
time. After a few minutes of walking your foot. Throughout this process a comfortable environment for
the pain decreases, because walking the surgeon rules out all the possible the foot.
stretches the fascia. For some people causes for your heel pain other than • Medications. Nonsteroidal anti-
the pain subsides but returns after plantar fasciitis. inflammatory drugs (NSAIDs),

2. such as ibuprofen, may help to help reduce the inflammation after several months of non-surgical
reduce pain and inflammation. and relieve pain. treatment, you continue to have heel
• Lose weight. Extra pounds put • Removable walking cast. A pain, surgery will be considered. Your
extra stress on your plantar fascia. removable walking cast may be podiatric foot and ankle surgeon will
used to keep your foot immobile discuss the surgical options with you
If you still have pain after several for a few weeks to allow it to rest and determine which approach
weeks, see your podiatric surgeon, and heal. would be most beneficial for you.
who may add one or more of these • Night splint. Wearing a night
approaches: splint allows you to maintain Long-term Care
• Padding and strapping. Placing an extended stretch of the plantar No matter what kind of treatment
pads in the shoe softens the fascia while sleeping. This may you undergo for plantar fasciitis, the
impact of walking. Strapping help reduce the morning pain underlying causes that led to this
helps support the foot and reduce experienced by some patients. condition may remain. Therefore, you
strain on the fascia. • Physical therapy. Exercises and will need to continue with preventive
• Orthotic devices. Custom orthotic other physical therapy measures measures. If you are overweight, it is
devices that fit into your shoe may be used to help provide relief. important to reach and maintain an
help correct the underlying ideal weight. For all patients, wearing
structural abnormalities causing Although most patients with plantar supportive shoes and using custom
the plantar fasciitis. fasciitis respond to non-surgical orthotic devices are the mainstay
• Injection therapy. In some cases, treatment, a small percentage of of long-term treatment for plantar
corticosteroid injections are used patients may require surgery. If, fasciitis. ▲
This information has been prepared by the Consumer Education Committee of the American College of Foot and Ankle
Surgeons, a professional society of 5,700 podiatric foot and ankle surgeons. Members of the College are Doctors of
Podiatric Medicine who have received additional training through surgical residency programs.
The mission of the College is to promote superior care of foot and ankle surgical patients through education,
research and the promotion of the highest professional standards.
Copyright © 2004, American College of Foot and Ankle Surgeons • www.acfas.org