Every mile you walk puts tons of stress on each foot. Your feet can handle a heavy load, but too much stress pushes them over their limits. When you pound your feet on hard surfaces playing sports or wear shoes that irritate sensitive tissues, you may develop heel pain, the most common problem affecting the foot and ankle. A sore heel will usually get better on its own without surgery if you give it enough rest. However, many people ignore the early signs of heel pain and keep on doing the activities that caused it. When you continue to walk on a sore heel, it will only get worse and could become a chronic condition leading to more problems.
If it hurts under your heel, you may have one or more conditions that inflame the tissues on the bottom of your foot. When you step on a hard object such as a rock or stone, you can bruise the fat pad on the underside of your heel. It may or may not look discolored. The pain goes away gradually with rest. Doing too much running or jumping can inflame the tissue band (fascia) connecting the heel bone to the base of the toes. The pain is centered under your heel and may be mild at first but flares up when you take your first steps after resting overnight. You may need to do special exercises, take medication to reduce swelling and wear a heel pad in your shoe. When plantar fasciitis continues for a long time, a heel spur (calcium deposit) may form where the fascia tissue band connects to your heel bone. Your doctor may take an X-ray to see the bony protrusion. Treatment is usually the same as for plantar fasciitis: rest until the pain subsides, do special stretching exercises and wear heel pad shoe inserts. Having a heel spur may not cause pain and should not be operated on unless symptoms become chronic.
The heel can be painful in many different ways, depending on the cause. Plantar fasciitis commonly causes intense heel pain along the bottom of the foot during the first few steps after getting out of bed in the morning. This heel pain often goes away once you start to walk around, but it may return in the late afternoon or evening. Although X-ray evidence suggests that about 10% of the general population has heels spurs, many of these people do not have any symptoms. In others, heel spurs cause pain and tenderness on the undersurface of the heel that worsen over several months. In a child, this condition causes pain and tenderness at the lower back portion of the heel. The affected heel is often sore to the touch but not obviously swollen. Bursitis involving the heel causes pain in the middle of the undersurface of the heel that worsens with prolonged standing and pain at the back of the heel that worsens if you bend your foot up or down. Pump bump, this condition causes a painful enlargement at the back of the heel, especially when wearing shoes that press against the back of the heel. Heel bruises, like bruises elsewhere in the body, may cause pain, mild swelling, soreness and a black-and-blue discoloration of the skin. Achilles tendonitis, this condition causes pain at the back of the heel where the Achilles tendon attaches to the heel. The pain typically becomes worse if you exercise or play sports, and it often is followed by soreness, stiffness and mild swelling. A trapped nerve can cause pain, numbness or tingling almost anywhere at the back, inside or undersurface of the heel. In addition, there are often other symptoms, such as swelling or discoloration - if the trapped nerve was caused by a sprain, fracture or other injury.
After you have described your foot symptoms, your doctor will want to know more details about your pain, your medical history and lifestyle, including. Whether your pain is worse at specific times of the day or after specific activities. Any recent injury to the area. Your medical and orthopedic history, especially any history of diabetes, arthritis or injury to your foot or leg. Your age and occupation. Your recreational activities, including sports and exercise programs. The type of shoes you usually wear, how well they fit, and how frequently you buy a new pair. Your doctor will examine you, including. An evaluation of your gait. While you are barefoot, your doctor will ask you to stand still and to walk in order to evaluate how your foot moves as you walk. An examination of your feet. Your doctor may compare your feet for any differences between them. Then your doctor may examine your painful foot for signs of tenderness, swelling, discoloration, muscle weakness and decreased range of motion. A neurological examination. The nerves and muscles may be evaluated by checking strength, sensation and reflexes. In addition to examining you, your health care professional may want to examine your shoes. Signs of excessive wear in certain parts of a shoe can provide valuable clues to problems in the way you walk and poor bone alignment. Depending on the results of your physical examination, you may need foot X-rays or other diagnostic tests.
Non Surgical Treatment
The podiatric physician will examine the area and may perform diagnostic X-rays to rule out problems of the bone. Early treatment might involve oral or injectable anti-inflammatory medication, exercise and shoe recommendations, taping or strapping, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used in conjunction with such treatments. A functional orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting the ligaments and tendons attaching to the heel bone. It will effectively treat the majority of heel and arch pain without the need for surgery. Only a relatively few cases of heel pain require more advanced treatments or surgery. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of a neuroma or other soft-tissue growth.
Surgery is a last resort in the treatment of heel pain. Physicians have developed many procedures in the last 100 years to try to cure heel pain. Most procedures that are commonly used today focus on several areas, remove the bone spur (if one is present), release the plantar fascia (plantar fasciotomy), release pressure on the small nerves in the area. Usually the procedure is done through a small incision on the inside edge of the foot, although some surgeons now perform this type of surgery using an endoscope. An endoscope is a tiny TV camera that can be inserted into a joint or under the skin to allow the surgeon to see the structures involved in the surgery. By using the endoscope, a surgeon can complete the surgery with a smaller incision and presumably less damage to normal tissues. It is unclear whether an endoscopic procedure for this condition is better than the traditional small incision. Surgery usually involves identifying the area where the plantar fascia attaches to the heel and releasing the fascia partially from the bone. If a small spur is present this is removed. The small nerves that travel under the plantar fascia are identified and released from anything that seems to be causing pressure on the nerves. This surgery can usually be done on an outpatient basis. This means you can leave the hospital the same day.
heel cups for achilles tendonitis
Maintaining flexible and strong muscles in your calves, ankles, and feet can help prevent some types of heel pain. Always stretch and warm-up before exercising. Wear comfortable, properly fitting shoes with good arch support and cushioning. Make sure there is enough room for your toes.