Heel pain is by far the most common foot complaint that affects millions of people around the world. Plantar Fasciitis is the ailment that is often associated with the symptoms of Heel Pain and Heel Spurs.

This article enumerates the features:

• What is Plantar Fasciitis?
• How does Plantar Fasciitis result in heel pain and heel spurs
• What is the treatment to relieve the discomfort of heel pain

Heel Pain Symptoms

Heel Pain, Heel Spurs, and Plantar Fasciitis are foot ailments that cause discomfort in the center of the heel when weight is placed on the foot, especially when one gets up in the morning. The pain slowly disappears after walking around for a short time. The pain can vary in severity from case to case or from time to time.

What Causes Heel Pain and Heel Spurs?

The most common cause of both heel pain and heel spurs is "Plantar Fasciitis" That is the Latin term designating the inflammation of the Plantar Fascia.

Plantar Fascia is that flat band of fibrous ligaments located under the foot that connects the heel bone to the toes. This dense strip of tissues acts like a bow string that spans the arch of the foot to give it support.

How does Plantar Fasciitis Develop?

The Plantar Fascia generally takes the full load of the body when the foot is placed on the ground. This transmits great force and stretches the Plantar Fascia to even out and flatten the arch of the foot to distribute the weight of the body. The bow and string analogy appropriately describes the arching of the foot by the Plantar Fascia.

Normally the Plantar Fascia is very tough and flexible to withstand forces transmitted during walking or running. The normal function can be however affected by excessive abuse of the feet, over-pronation, old age or being over-weight. As a result of the painful stretching the Plantar Fascia exhibits micro-tearing that leads to irritation, inflammation and pain at the junction of the Plantar Fascia and calcaneus or heel bone. The continued pulling of the Fascia joined to the heel bone can result in a bony growth on the heel commonly known as a Heel Spur. This growth triggers pain in the surrounding tissues that get inflamed.

During the rest periods when you sleep or sit for a long time the Plantar Fascia contracts and becomes tight. Initial movement or sudden getting up results in rapid application of body weight to the foot whereby the Fascia must quickly lengthen. This causes micro-tearing in the ligaments and stabbing pain for the first few minutes as you take steps.

How over-stretching of the Plantar Fascia normally occurs:

• Suffering from over-pronation (flattening of the arch)
• Long duration standing or walking on hard surfaces
• Overweight, obesity, or pregnancy
• Achilles tendons and tight calf muscles

Treatment for Heel Pain

A majority of patients can find relief through a conservative or non-surgical treatment of Plantar Fasciitis. Common remedies in this case are:

• Ice Packs - This should be applied to the inflamed area
• Night Splint - The mild stretching caused by night splints help in tensioning the calf muscles and Plantar Fascia
• Shock wave therapy - Shock wave pulses applied through a special machine helps in relieving the soreness
• Anti-inflammatory drugs - Ibuprofen drugs help in the relief of heel pain
• Cortisone injections - The steroid treatment is locally administered in the heel area

The foregoing "short-term" remedial measures assist in relieving heel pain. As Plantar Fascia excessively stretches due to over-pronation (fallen arches) and tightening of the calf muscle and ligaments it is advisable to undergo long term treatment that has recently been found to be quite effective.

The American Orthopedic Foot and Ankle Society (AOFAS) conducted a two year national study on treatments of heel pain. This study clearly demonstrated that the best course of cost-effective treatment is a strict regime of using "off the shelf" orthotics (arch supports) and a specific stretching program. The treatment resulted in 90 percent of patients experiencing substantial relief from heel pain symptoms.

These orthotic insoles help in correcting abnormal foot mechanics and over-pronation through providing support to the Plantar Fascia and releasing the undue strain. Thus it treats the root cause of Plantar Fasciitis. Orthotics are further helpful if combined with a daily regime of stretching and strengthening of the Plantar Fascia, the Achilles tendons, and the calf muscles. Such exercises need not take no more than 5 to 10 minutes per day.

Surgery

Surgery is the very last resort for the treatment of heel pain and should only be considered when all other conservative treatment has failed. In the surgical intervention the Plantar Fascia is partially released from the bone and any spur removed if found to be present. The pressure on the small nerves that traverse under the Plantar Fascia is released after proper identification of the cause.