Heel pain (planter fascitis)
Heel pain is mostly due to planter fascitis which is inflammation of the (fascia) thick band of tissue at the bottom of your heel that runs from your heel to your toes.
Pain start when you start walking in the morning or after an sitting for a while and improve with continuous walk but it might return after long periods of standing or when you stand up after sitting.
Your fascia supports the muscles and arch of your foot. When it’s overly stretched, you can get micro tears in that fascia. This can bring the pain and inflammation.
You’re at greater risk of plantar fasciitis either due to degeneration of fascia or due to extra stress on fascia if
You are 40 to 60 years old
You do some exercise like long distant running or dancing
You are overweight
You spend many hours standing each day
You wear worn-out shoes with thin soles
You have flat feet or high arches
You have an unusual walk or foot position like flat foot or high arched foot
You often wear high-heeled shoes
Symptoms (what you feel)
Stabbing pain start at bottom of heal when take first step
It will improve with exercise and walk but triggered by long periods of rest or standing
Diagnosis
Physical examination (what your doctor feel)
Clinical diagnosis is confirmatory diagnosis for planter fascitis
Your doctor will check your foot for maximum tenderness and you feel severe pain at point of heel when your doctor press an specific area at heel.
X-ray
It is clinical diagnosis so no need of X-ray but doctor might suggest an X-ray to rule out another problem.
In X-ray there may be bony growths called heel spurs. That heel spurs are the result inflammation not the cause of plantar fasciitis.
Treatment
conservative treatment
Conservative treatment such as medicine, rest, icing, supportive shoe or shoe insert, extra cushioning or arch support and physiotherapy is sufficient for most of patients
Once you begin treatment, you’ll usually see improvement within 1 to 2 months If conservative treatment aren’t working after several months, your doctor might recommend
surgical treatment
Injection therapy according to some theory
Surgery
Very few people require surgery for planter fascitis. Surgery can be done with small open procedure or with arthroscope.
we are providing dedicated physiotherapy for planter fascitis and both type of surgical options (open and arthroscopic) if not relieved by conservative treatment.
We never provide injection therapy for planter fascitis as it may cause damage to fat pad of heel so it can turn in to very difficult to treat.