All The Things You Ought To Know About Heel Painfulness
Heel pain is unlike most body aches and injuries because heels can’t be immobilized to rest and recover, at least without considerable inconvenience to the sufferer. Heels can?t be isolated and splinted either ,as body weight will continue to aggravate the condition with every step. Heel pain can be devastating if left untreated, eventually impairing the ability to walk comfortably-or at all. Most Heel Pain comes from tendon problems, though some types can come from bone issues as well.
If you have pain behind your heel, you may have inflamed the area where the Achilles tendon inserts into the heel bone (retrocalcaneal bursitis). People often get this by running too much or wearing shoes that rub or cut into the back of the heel. Pain behind the heel may build slowly over time, causing the skin to thicken, become red and swell. You might develop a bump on the back of your heel that feels tender and warm to the touch. The pain might flare up when you first start an activity after resting. It often hurts too much to wear normal shoes. You may need an X-ray to see if you also have a bone spur.
The symptoms of plantar fasciitis include pain along the inside edge of the heel near the arch of the foot. The pain is worse when weight is placed on the foot especially after a long period of rest or inactivity. This is usually most pronounced in the morning when the foot is first placed on the floor. This symptom called first-step pain is typical of plantar fasciitis. Prolonged standing can also increase the painful symptoms. It may feel better after activity but most patients report increased pain by the end of the day. Pressing on this part of the heel causes tenderness. Pulling the toes back toward the face can be very painful.
The diagnosis of plantar fasciitis is generally made during the history and physical examination. There are several conditions that can cause heel pain, and plantar fasciitis must be distinguished from these conditions. Pain can be referred to the heel and foot from other areas of the body such as the low back, hip, knee, and/or ankle. Special tests to challenge these areas are performed to help confirm the problem is truly coming from the plantar fascia. An X-ray may be ordered to rule out a stress fracture of the heel bone and to see if a bone spur is present that is large enough to cause problems. Other helpful imaging studies include bone scans, MRI, and ultrasound. Ultrasonographic exam may be favored as it is quick, less expensive, and does not expose you to radiation. Laboratory investigation may be necessary in some cases to rule out a systemic illness causing the heel pain, such as rheumatoid arthritis, Reiter’s syndrome, or ankylosing spondylitis. These are diseases that affect the entire body but may show up at first as pain in the heel.
Non Surgical Treatment
If the plantar fasciitis is acute, that is, a sprain of the plantar fascia then it is basically treated as a sprain, with anti-inflammatory drugs, ice, rest, possibly physical therapy. If chronic, the poor foot mechanics need be addressed. Foot mechanics are changed by use of specially moulded shoe inserts known as orthotics. Someone with plantar fasciitis needs an orthotic designed to relieve strain on the plantar fascia. Orthotics are often confused with arch supports. Arch supports, by holding up the arch can remove some of the tension from the plantar fascia. Orthotics, on the other hand, do most of their work on the heel and ball of the foot repositioning the foot for maximized function. What can you do before you see the foot doctor? First, try doing your own version of deep tissue massage by rolling a frozen cola bottle or can from the heel forward into the arch. Do it gently. Do stretching but the key to good stretching is not to stretch too hard so generally avoid weight bearing (standing) stretches but sit on a soft surface like your bed and pull the foot backward on the leg as far as it will go, holding for 20 seconds and relaxing for 5 seconds. Each 25 second ?set? can be repeated 5 times and you have invested about 2 minutes in giving yourself a lot of help. Watch out for the shoes you wear. It is tempting to obtain shoes that are colorful and soft. Here is the proof that soft shoes are bad. Wrap a pillow around your foot with duct tape and walk for a block or two. You will come back with your foot hurting more because your foot sank down deeper into the soft surface, allowing the ligament to stretch more. The shoes should be stiff in the shank and flexible at the ball. Such shoes, to running buffs, are known as motion control shoes or stability shoes so going to one of the small specialty running shoes stores is a good place to start. If you don?t have a desk job, or have an industrial job see if light duty is available. A note from your doc may be all that is required in most cases and most doctors are happy to oblige.
Surgery to correct heel pain is generally only recommended if orthotic treatment has failed. There are some exceptions to this course of treatment and it is up to you and your doctor to determine the most appropriate course of treatment. Following surgical treatment to correct heel pain the patient will generally have to continue the use of orthotics. The surgery does not correct the cause of the heel pain. The surgery will eliminate the pain but the process that caused the pain will continue without the use of orthotics. If orthotics have been prescribed prior to surgery they generally do not have to be remade.
Before you get out of bed in the morning, and then periodically throughout the day, do the following exercises to increase flexibility and ease pain. Slowly flex your foot and toes to stretch the tissue on the bottom of your sore foot. Hold the stretch for 10 counts. Relax and repeat. Do gentle ankle rolls to keep the tissues around the ankle and on the back of the heel flexible. Sit on the edge of your bed and roll your foot back and forth over a tennis ball.