Everyday I have patients come into the office with chief complaint of heel pain. Many of these patients will say to me that they have been told they have a heel spur or that Google told them they have a heel spur.
Although heel pain CAN be caused by a heel spur, this is usually not the case. Heel pain is most commonly caused by a condition known as, plantar fasciitis. This is inflammation of the ligament on the bottom of your foot that attaches to your heel bone. This ligament is similar to an elastic band. When you are sitting it gets very tight, then when you step down it stretches out. As it stretches, it pulls at the heel bone where it inserts, causing pain and inflammation. This pain is most commonly felt first thing in the morning or after periods of sitting. Patient’s with chronic plantar fasciitis, will frequently develop a heel spur, from the constant pulling of the ligament on the bone. In these cases, however, this heel spur is usually not the cause of the pain.
What can cause a heel spur?
- Chronic plantar fasciitis
- Arthritis (ie. Reiter’s, Rheumatoid)
How do we treat plantar fasciitis?
Plantar fasciitis is initially treated with steroid injections along with anti-inflammatories, stretching and icing. Once the pain is resolved, it will be important to keep stretching daily in order to keep the ligament loose. It is also important to get into a supportive shoe with an insert, to give that ligament more support. In the few patients who do not get relief with the previous treatments, we then look to other options, such as ultrasound and physical therapy. If you are a patient with reccuring plantar fasciitis, you may want to consider a small procedure where we cut the plantar fascia so that it is no longer causing you pain. This is called an Endoscopic Plantar Fasciotomy. Less frequently than this, you may also need the bone spur removed, if there is one.
By James Heilman, MD – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=49068272
It’s Not Always Plantar Fasciitis…
Although it is common, plantar fasciitis is not always the cause of your heel pain. Heel pain can also be caused by a condition known as Tarsal Tunnel Syndrome. This is inflammation of the nerve that travels from the inside of your ankle to the bottom of your foot. This is frequently associated not only with pain, but tingling, numbness and burning. Other causes of heel pain can be fracture, bone tumors, or even diabetic neuropathy.
If you are unsure of the causes of your heel pain, call Hollowbrook Foot Specialists today, at (845) 298-9074, for an appointment. We are serving the Hudson Valley area from Wappingers Falls.