Pain in the heel has become a common problem among the young and the old these days. The onset of heel pain is gradual. Initially patient experiences the pain early in morning but later on it is experienced during walking. There are various reasons for heel pain ranging from planterfascitis, calcaneal spur, calcaneal bursitis; fat pad syndrome etc. but planterfascitis is one of the most common causes of heel pain.
WHAT IS PLANTERFASCITIS?
It is an inflammation of the planter fascia that extends from heel to the toes. It supports the arch of foot by acting as a "bowstring". Fascia first becomes irritated and then inflamed, resulting in the pain.
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WHAT CAUSES PLANTERFASCITIS?
o Biomechanical abnormalities in functioning of foot.
o Poorly designed footwear puts abnormal strain on the fascia.
o Long periods of standing /walking on hard, flat surface in poor shoes.
o Lack of flexibility in calf muscles.
o Overweight.
SYMPTOMS
o Heel pain with first few steps in morning.
o Inability to walk comfortably on the affected side.
o Pain may be sharp like a stone bruise, thrombing or burning.
DIAGNOSIS
o Medical history and physical examination by physician or physiotherapist to rule out all possible causes for heel pain.
o Imaging tests like X-ray, MRI may help confirm diagnosis.
TREATMENT
Treatment of heel pain depends entirely on the cause of problem. Most patients with heel pain are cured by physiotherapy treatment and a small percentage of patients may require steroid injection or surgery. Physiotherapy programme includes
o Reduce your activity level. Take a few days off jogging or prolonged standing/walking.
o Cryotherapy - Apply ice regularly three to four times daily, it is crucial to provide pain relief.
o Taping - Physiothe-rapist can strap your heel using tape to support the foot so that you can move more easily with less pain.
o Stretching exercises for planter fascia.
o Sit down and cross your affected leg over your other leg
o Place your figure across the base of your toes
o Pull the toes back until you feel a stretch in the arch of your foot.
o Strengthening of foot muscles with faradic foot bath.
o Shoe modifications heel wedge can help protect the fascia and increase arch support.