What is Plantar Fasciitis a.k.a. Heel Spur Syndrome?
Plantar fasciitis, a condition also known as heel spur syndrome, is an inflammation of the plantar fascia—a band of tissue that runs from your heel to your toes. This inflammation is typically caused by an abnormality in the structure of the foot, such as extremely high arches or flat feet—or by an external irritation, such as non-supportive footwear over long periods of time.
The ligament supporting your arch swells and tightens on a regular, daily basis. If your ligament becomes overworked or strained, you feel pain in your heel known as plantar fasciitis. Continuing to use your foot after swelling of your ligament causes small microtears, increasing injury further.
What is a Heel Spur?
A heel spur is a bone-growth that looks like a spur at the insertion of the plantar fascia on the heel. They’re seen more frequently in people with painful heels but they are also seen quite frequently in people that have no pain. The presence or absence of a heel spur does not make the diagnosis of plantar fasciitis but does suggest the presence of the disease. The spur does not (usually) need to be removed to alleviate heel pain. Many many people live their whole lives with heel spurs with no pain in their heels.
Do I have plantar fasciitis?
There are several clues that help to make the diagnosis of plantar fasciitis (PF) as opposed to the other causes of heel pain. They are not 100% but taken together they do help. When you get out of bed in the morning, are your feet sore and stiff? This often occurs with inflammation of the ligament in your foot directly causing plantar fasciitis.
- Location of pain. Plantar Fasciitis usually hurts on the plantar medial aspect of the heel. This is on the inside of the heel. Pain can also extend into the arch. If the whole bottom of the foot is sore it may be something else.
- Timing of pain. Plantar Fasciitis usually hurts more the first steps of the morning as you get out of bed. It also usually does not hurt when you get off your foot. If you have pain after laying down that lasts for more than a few minutes it is more likely to be nerve pain.
- Relief with a few steps. In the early stages of plantar fasciitis the pain subsides after being of the feet for a few minutes. As the tissues get stretched and warmed up the pain decreases. When it gets more severe the pain persists.
What causes plantar fasciitis?
With so many reasons for your plantar fasciitis, speak with a healthcare professional about your specific cause and how you can prevent future inflammations.
Here are some common causes of plantar fasciitis:
- Poor workout routines
- Overuse injuries
- Weight gain
- Tight Achilles tendons
- Low or falling arches
- Poorly fitting shoes
- Sudden changes in exercise
Is plantar fasciitis common?
About 2 million people every year receive a plantar fasciitis diagnosis. It’s the most common cause of pain in the heel, but luckily, the condition is easy to manage with correct treatment and early detection.
Your podiatrist uses different physical tests and diagnostic images when diagnosing plantar fasciitis. Plantar fasciitis is most common in long-distance runners, people who stand a lot, and overweight people.
What can be done to diagnose your Heel Pain?
Probably the most important thing that a podiatrist can provide you with is the correct diagnosis. In our office we use diagnostic ultrasound and x-rays to evaluate the patient and make the correct diagnosis. In about 10% of the patients that come into our office, the plantar fascia is not involved in the patient’s pain.
Do I need to worry about Heel Pain in Children?
Short answer, yes! One of the most common childhood complaints, heel pain is often caused by Sever’s disease. Sever’s disease is the result of the growth plates in the heel growing faster than the Achilles tendon, which causes irritation and pain as the tendon and other muscles tighten. Dr. Silvester can help treat symptoms effectively and economically with shoe inserts and therapy.
Learn more: Sever’s Disease and Heel Pain
Children suffer from many other foot conditions, if your child complains about their feet “being tired” or hurting, please visit our Pediatric Foot Care page to learn more.
When do I need to see a doctor for my heel pain?
As with all conditions, heel pain is much easier to treat when it is caught early. If you have had pain for 4-6 weeks get an appointment with a good foot doctor (we like us) :). Most of our heel pain patients are 80% improved in one week after seeing us. They might not be cured but they sure feel better. Healing the damaged tissue takes time. If you have had heel pain for one year it is going to take more effort than if you have had it for one month.
What are possible treatments for Plantar Fasciitis?
Treatments for plantar fasciitis can vary depending on the severity and nature of your inflammation. Sometimes, simple at-home options such as stretches, ice packs, and shoe modifications can help reduce irritation, and are often initially prescribed to reduce pain and symptoms. If the pain continues, more aggressive treatments such as night splints and casts, injections, or orthotics are employed.
If you truly have plantar fasciitis that’s all you have, we have a wonderful treatment plan that usually can get you feeling better fairly quickly (a few days). We follow that up with long-term plan to heal the damaged tissue. This is all determined by how you are doing with our therapies. On your first visit our goal is to have you 85-90% better in 2-5 days. To do that we do several things all at once. This approach has been very successful for our patients. Most of the things mentioned above are in that plan. We also include medications, injections, night splints, and nutritional supplements. We have an array of therapies not available in most clinics if needed.
Advanced therapies available at Next Step Foot and Ankle Clinic:
- Shockwave therapy. Shockwave therapy if appropriately applied has been shown to be as effective as surgery. It does not interrupt your activities of daily living, has a very quick results in general, and can help induce long-term healing to the tissues. Shock wave has been shown to be as effective as surgery for plantar fasciitis.
- Injectable extracellular matrix to help you heal faster. Frequently if the heel pain has been present for a long time or is significant degeneration in the ligament (plantar fascia). This treatment can provide a structural repair model for the tissue to heal itself. This is often used in conjunction with shockwave therapy. Also, we occasionally use amnion injections to help tissue heal.
- We also address possible joint contractures that can contribute substantially to heel pain. We have specialized equipment that we dispensed to the patient that can treat these conditions and promote healing without interrupting the patient’s lifestyle.
- Orthotic therapy. Almost every podiatrist does orthotics. Unfortunately, the vast majority of orthotics dispensed are nothing more than expensive arch supports and do not take into consideration what the patient’s foot is like. We do a good exam so when you get your orthotic it really controls your foot and decreases stress on the plantar fascia. We have the most advanced digitized foot scan and dynamic pressure plate analysis platform commercially available.
- Minimally invasive surgery. Sometimes, nothing else works so surgery is necessary. We use many different types of surgical approaches to heel pain one of them that is very helpful is a percutaneous procedure where the incision is about as wide as a pencil lead. This results in a very quick return to work and activity.
- Laser therapy. We have the gold standard in laser therapy. It is a robotic computerized laser that provides multiple benefits: Anti-inflammatory, analgesic, accelerated tissue repair, and improved vascularity are just a few.
- Any combination of the above, by combining these modalities we can magnify the effects.
As mentioned above, specific instructions in stretching and strengthening of the foot can be given. Also we can provide you with appropriate suggestions on shoe gear and arch supports or custom orthotics. Additionally, injections can be given. There are other devices that we use in the treatment of heel pain as well such as night splints, and occasionally cam walkers.
When is surgery necessary for my heel pain?
If you have had heel pain that won’t go away for 3-6 months then surgery is a consideration. There are other considerations of course. These include the severity of the pain, contributing factors, associated diagnoses and the overall health of the patient, social factors etc.
What types of surgery are available for plantar fasciitis?
There are very minimally invasive procedures available for chronic plantar fasciitis. These require an incision that is about the width of a pencil. These can be done endoscopically or with the use of an ultrasound. The success rate of this kind of surgery is about 90%. There are also more traditional open procedures. These require a much longer recovery. These surgeries can be combined with some of the advanced therapies listed above to speed the recovery and increase the success of the surgery. In general, If we perform surgery on heel pain we use these minimally invasive techniques 1st.
Why does surgery for plantar fasciitis fail?
Heel pain surgery fails for two reasons most of the time:
- Failure to make the correct diagnosis
- Failure to address all the problems that are causing the heel pain
Frequently nerve pain is involved and the doctor has not even looked at that possibility. A short Achilles tendon should also be addressed. But if these factors are addressed during the surgery the success rate is usually very high. Of course there can be other reasons for failure but these are the most common.
Will plantar fasciitis go away?
Most cases of plantar fasciitis go away after treatment methods such as:
- Wearing supportive shoes
- Reducing high-impact activities like running
- Regular stretching
- Night splints
If you don’t see ideal results, your doctor may recommend surgery. The surgery releases the ligament in your foot from the bone. Without the ligament pulling on your bone, the pressure and strain from plantar fasciitis — and your pain — disappears.
Instead of suffering from sore heels and feet when you first wake up or after sitting for a long time, get treatment from the dedicated staff at Next Step Foot & Ankle Clinic in Pleasanton or Universal City, Texas, by calling for an appointment or fill our our Appointment Request online.
Dr’s Educational Presentations
- High Arch Feet
- How to Relieve Heel Pain without Surgery
- Using a Night Splint for Heel Pain
- How to Treat Chronic Heel Pain
- Shockwave Therapy
- MLS Laser Therapy
- One-Two Punch for Foot Pain
Blog Articles on Heel and Arch Pain
- Heel Pain: What You Need to Know
- Rehab Your High Arches with Toe Exercises
- An Overview of Heel Pain
- Say Farewell to Heel Fissures
- Haglund’s Deformity: Bumps on Heels
- Cavus Foot: Abnormally High Arches
Videos on Stretches for Heel and Arch Pain
- Stretches for Heel Pain
- Arch Strengthening Exercises
- Strengthening Foot Muscles
- Podiatrist Recommended Stretches to Relieve Heel Pain
- Why does my high-arched foot hurt?
- What is the difference between tendinitis and bursitis?
- What are the main causes of heel pain?
If you are ready to wake up with pain-free heels and arches without problems, Next Step Foot & Ankle Clinic has a solution for you.
Contact Our Office Today to Set Up Your Consultation Appointment!
Browse our website to learn more about our services, or contact us directly at 210.375.3318 to schedule an appointment.