Sunday, September 23, 2012

Heel Spur and Plantar Fasciitis

Surviving with heel pain or plantar fasciitis.
Have you ever been unlucky enough to be struck down with the pain of a heel spur? I have and if you have too then you'll know just how debilitating it can be. But - as with all things medical - understanding the cause can go along way to providing relief and reassurance.
So... lets begin by asking "what is plantar fasciitis?"
Plantar means the sole of the foot, fascia means gristle and "-itis" means inflammation (as in tonsillitis, dermatitis, appendicitis, conjuctivitis etc etc. Plantar Fasciitis, then, simply means "inflammation of the gristle on the sole of the foot."
The heel pain of plantar fasciitis is felt at the front of the heel and the pain often spreads along the sole of the foot towards the big toe. The heel pain is agonising when walking - particularly first thing in the morning. Putting your foot to the ground on getting out of bed in the morning is usually something you learn to dread because the gristle of the foot (the fascia) tightens up overnight as a result of the inflammation. The tight area is stretched as you put your weight onto the foot - causing a searing pain along from the heel to the base of the big toe.
Sometimes the inflammation encourages calcium or new bone to grow along the line of the fascia on the sole of the foot. This creates a spurred effect when the heel is seen on x-ray. You can see a heel spur x-ray on my website by following the link at the bottom of this article.
Plantar fasciitis or heel spur pain eventually settles without treatment in about 80% of cases but it may take many months to do so.
Common triggers for heel pain or plantar fasciitis include: poor footwear and a long walk (wellington boots in winter, tight calf muscles or achilles tendon tissues and flat feet or other changes in the shape of the arch of the foot.
Plantar fasciitis heel pain can happen at any age but is commoner in the elderly and in those who are overweight.
Treatment options for plantar fasciitis heel pain include: physical therapy including stretches and massage (this works but it can take a while), injection of the tender area with steroid and local anaesthetic (effective but can be painful if done by an inexperienced doctor), anti-inflammatory medication (not usually very effective and may have side effects) and orthotic insoles or heel cushions ( effective but can be uncomfortable in your shoes).
I find it is often better to invest in a pair of good quality running shoes with a deep cushion sole. This solution is often very effective - but not entirely fashionable if you're more than 35yrs old!
If you are unlucky enough to suffer from this kind of heel pain then the best advice I can give is to STAY POSITIVE - the heel pain of plantar fasciitis will eventually go away even without treatment.
Dr Gordon Cameron MD is based in Edinburgh, Scotland. He is a specialist in treating joint and muscle pain.