Features October 2017 Issue

Heel Pain May Be Plantar Fasciitis

Heel pain can be frustrating, but treatment is effective for most people with plantar fasciitis.

If you feel stabbing pain in your heel every morning when you get out of bed that lessens after you start walking, you may have plantar fasciitis. Plantar fasciitis is inflammation of the plantar fascia, a long ligament on the bottom of the foot that originates from the heel bone and attaches to the toes.

“It helps keep the foot stable,” says Stella Chiunda, DPM, a podiatrist at Cleveland Clinic. People with plantar fasciitis may also have heel pain after prolonged standing or sitting or after exercise.

Commonly called runner’s or jogger’s heel, plantar fasciitis is the most frequent cause of heel pain. Although several factors may lead to plantar fasciitis, it is generally believed to be caused by repeated overuse of the foot. This causes stress on the plantar fascia, which can develop small tears and become inflamed, both of which lead to the characteristic heel pain.

You are at risk of developing plantar fasciitis if you are overweight, a runner or have a job that requires you to stand or walk on hard surfaces. Certain types of arthritis place one at a higher risk of developing plantar fasciitis. “People with inflammatory arthritis can develop plantar fasciitis as part of the disease course,” says Dr. Chiunda. Those with osteoarthritis have the same risk of plantar fasciitis as people without arthritis.

Is It Arthritis or Plantar Fasciitis?

How can you tell if you have foot arthritis or plantar fasciitis? Dr. Chiunda explains that arthritis of the foot is joint specific. “The symptoms of arthritis in the foot will vary depending on which joint is involved,” says Dr. Chiunda.

There are no joints on the bottom of the heel. “With fasciitis, one experiences heel pain on the bottom of the heel, typically the inside of the heel,” explains Dr. Chiunda. The pain may extend up the back of the heel.

“Foot pain from plantar fasciitis can limit your ability to go about daily activities efficiently,” explains Dr. Chiunda. Heel pain can cause limping, restrict participation in sports or leisure activities, and cause problems at work. “Sometimes foot pain can lead to ankle, knee, hip or lower back pain, which is mostly due to compensation for the pain in the feet,” says Dr. Chiunda.

Plantar Fascitis

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Inflammation of the plantar fascia ligament, which runs along the bottom of the foot, is the most common cause of heel pain.

Treatment Options

Simple treatment methods are effective for 90 percent of people with plantar fasciitis. “It can sometimes be a challenge to get rid of plantar fasciitis in patients with inflammatory arthritis,” says Dr. Chiunda. Initial treatments include icing, anti-inflammatory pain medications (such as ibuprofen [Motrin®, Aleve®]), stretching, arch supports and good supportive shoes.

Persistent pain may be treated with physical therapy, customized orthotics, a corticosteroid injection, a splint at night, a walking boot or a cast. If pain continues after several months of these conservative treatments, more aggressive treatments can be used, such as shock wave therapy, Tenex Health TX® (a minimally invasive procedure to remove scar tissue), platelet rich plasma injections or surgery to cut the fascia.

Preventing Plantar Fasciitis

If you have inflammatory arthritis you are at increased risk of plantar fasciitis, so you should take preventive measures. “Foot pain can get frustrating and debilitating,” says Dr. Chiunda. Maintaining a normal weight, wearing supportive shoes, and avoiding excessive walking or running will help to keep your plantar fascia healthy.

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