If you suffer from from heel pain in Greater Hamilton area including Dundas, Ancaster, Stoney Creek. You may want to visit our clinic in Ancaster or in Stoney Creek. We have a wide assortment of treatment options for the heel pain.
Most heel pains are the worst in the morning. First few steps out of bed are the most painful. After a few moments pain seems to subside, just to come back after you sit down. Very often the 1st episode of the heel pain goes away on its own, although it does return in a few months and returns with vengeance. Every time heel pain comes back it lasts longer and it is a lot more intense
There are 4 conditions most frequently responsible for the for the pain in the heel. Number 1 would be plantar fasciitis. Number 2 is heel spur syndrome. Number 3 is actual heel spur. Number 4 is Achilles tendinitis.
See the different conditions below.
1. Plantar fasciitis is a condition that describes inflammation of plantar fascia itself or the site of its attachment to the heel bone. This is an inflammation of connective tissue. Plantar fascia is a big tendon like structure stretching all along the arch of the foot from the heel bone to all 5 toes. What causes plantar fasciitis? Microscopic tears in this connective tissue is the real cause which over time causes inflammation. Microscopic tears are caused by over-exertion (too much tension), in turn, over-exertion can be caused by structural deformity, usually over-pronation or excessive flattening of the foot, which lengthens the arch and puts extra tension on plantar fascia. Plantar fasciitis may also be aggravated by excess weight or arches that are too high or other biomechanical underlining imperfections of the foot.
2. Special attention on “plantar calcaneal enthesopathy” – heel spur syndrome. X-ray exam in this situation will NOT reveal a large plantar heel spur. Although, on palpation heel spur area is very tender. This condition develops when plantar fascia is stronger than its attachment point to the bone. In this situation the bone itself is throng. Plantar fascia itself is strong but the Junction is the weak spot where the very superficial layer of the bone is lifted up and a small bruise is formed on the heel bone (small hemathoma right under periosteum). This is why it feels like a knife stabbing in the heel.
3. Generally speaking, spurs are very common condition in the feet. Spurs themselves are harmless, they are small outgrowths of the bone. They may develop around the big toe joint, near any toe joints, but most frequently found in the heel. Depending on the location off three spur it may cause pain, irritation, pressure spots, which may lead to other foot problems. Actual heel spur. When the foot rolls (over pronates) for a long period of time, plantar fascia pulls on the heel bone where it inserts and over the years forms boney heel spur. They may form a large heel spur on the bottom (or plantar aspect) of the foot. This structure can be palpated and clearly be visible on the x-ray exam. Sometimes heel spurs can measure about a centimeter in size (1/2″). In this case pain is more prevalent on standing or walking and progresses as the day goes on. Often this type of heel pain diminishes when person sits down or takes the weight off it. The amount of pain does not always correlate with size of heel spur. Sometimes even large heel spur does not cause any pain. In more severe cases this spur may cause heavy callus to form at the bottom of person’s heel and under certain conditions may lead even to ulcer formation.
4. Achille’s tendinitis. It hurts in the posterior aspect (the back) of the heel. Pain starts with the first steps in the morning and increases as the day progresses. In the initial stages morning stiffnes and aching goes away as the leg muscles and tendons warm up. Achilles tendon is designed to accelerate the entire human body forward on every step. It may withstand in excess of 1000 pounds. Despite all of that it is the tendon in humans that is most likely to be injured and ruptured due to sports injury. This is an overuse injury. Anybody who is walking or running, amateur jogger or a professional runner, may be a subject for this common injury.
Achilles tendinitis often happens together with Plantar fasciitis.
Most probable causes may include:
a. Over-pronation, under-pronation
b. Stiffnes (lack of elasticity) or shortness of calf muscles.
c. Uphill running, stairs.
d. Too rapidly increasing speed or mileage of running.
e. Incorrect running shoes or ill fitting ones.
f. Lack of warm-up and stretching.
g. Starting too vigorously after a longer period of inactivity (winter).
h. Getting off the high heels too rapidly.
i. Sudden hard contraction of calf muscles i.e. sprinting.
Heel Pain Treatment Options
Best results are achieved by using combination of the following treatments. Depending on severity of the condition and personal factors combinations may vary.
Taping of the Foot
Specially designed sports tape is used and it is applied in a very specific manner to reduce the tension on the Achilles tendon. Generally this is a very well tolerated treatment. It helps to reduce the pain very rapidly. Patients can keep this tape on the foot for about a week at a time. It should be reapplied after 7 days or so.
Cold Laser Treatment
Cold Laser proved to be very effective In reducing the pain in the Achilles tendon and its insertion point. Cold laser therapy sessions should be repeated every 2 or 3 days and should consist of at least 4 or 6 treatments.
Non-Steroidal Anti-Inflammatory Medication
Taking non-steroidal anti-inflammatory medication. PLEASE CONTACT YOUR PHYSICIAN BEFORE TAKING ANY MEDICATION.
Shock Wave Therapy
Shock Wave Therapy and Radial Sound Wave Therapy are extremely effective modalities. Many patients feel significant relief even after a few treatments. Some studies suggested that this treatment may be successful in up to 88% of cases.
Custom Made Foot Orthotics
Prescription custom made foot orthotics. This is a long term treatment. It should be and integral part of any treatment combinations because orthotics correct the underlying biomechanical problem and Relieve the stress on the tendons.
Stretching programs should be designed to stretch the groups of muscles that are shortened. Exercise programs should be geared towards strengthening the weaker group of muscles. These muscles usually are in the front of the leg they are the upward flexors of the toes and a leg.
Ultrasound treatment may be introduced ….
Steroids injections are widely used to relieve the heel pain in plantar fasciitis and heel spurs. They provide rapid and rather long lasting (not permanent though) effect.
Most extreme cases may require surgical procedure.