Heel and Arch Pain (Spurs/Plantarfasciitis)

One of the most common condition we see here at Podiatry Professionals is heel pain and chances are that you or someone you know have or have experienced heel pain. There are a multitude of factors which can contribute to why you would get heel pain, and at Podiatry Professionals our podiatrists analyse, identify, assess and diagnose the major causes of your heel pain and manage it accordingly. An individual and tailored approach is conducted for each presenting patient to suit your individual situation. Resolving heel pain is an art which we see at our podiatry Canberra clinic everyday, you don’t have to continue to put up with heel pain as if treated early our podiatrists can often resolve your heel pain within 2-3 treatments and a lot of the time much sooner! 

Plantar fasciitis and heel spurs are the most common causes of pain in this area which can develop into particularly painful conditions if left untreated.

What is plantar fasciitis?

Plantar fasciitis and heel spurs (calcification under the heel bone) are common foot disorders affecting the heel and underside of the foot. It is characterised by heel pain and pain in your plantar fascia—a strong and dense connective tissue structure on the sole of your foot that supports your foot arch.

Your plantar fascia ligament is imperative to our feet as it helps the bones of your foot absorb the stresses of standing, walking and running and commonly it is most painful at the point where your plantar fascia attaches to your calcaneus, or heel bone.

It is very common for people with plantar fasciitis to experience pain during the first few steps out of bed in the morning in the heel of your foot which can improve as the foot warms up. Plantar fasciitis is an overuse injury which involves inflammation, micro tears and degeneration of the arch ligament and presents most commonly in active women more so than me between the ages of 40 and 60 years old.

X-rays are a commonly used diagnostic imaging technique to evaluate the possibility of a bone spur as an indication of your heel pain. A bone spur, if it is present in this location, is probably not the cause of your pain, but it is evidence that your plantar fascia has been exerting excessive force on your heel bone and developed calcification in the area.

Causes of plantar fasciitis

A number of factors can contribute to plantar fasciitis but you’re more likely to develop plantar fasciitis if you:

  • Are overweight.

  • Take up a new form of exercise or suddenly increase the intensity of your exercise.

  • Are on your feet for several hours each day.

  • Have other underlying medical conditions such as rheumatoid arthritis or lupus (systemic lupus erythematosus).

  • Tend to wear high-heeled shoes for long periods.

  • Wear shoes that are worn with weak arch supports and thin soles.

  • Have flat feet or an unusually high arch foot type.

  • Have leg length differences or an abnormal gait cycle or foot position.

  • Have calf muscle shortening/tightness

  • Have plantar fascia contracture

Treatment for plantar fasciitis

Footwear: Wearing shoes that allow your feet to be in their natural position is the most important treatment for plantar fasciitis. Shoe characteristics that are required are low heel height, wide toe box and have adequate support are most appropriate for this foot problem

Stretching: Calf and plantar fascial stretches are imperative in treating the pain of plantar fasciitis. They are easy to do, your podiatrist will talk you through accurately how best to do these exercises.

Taping techniques: There are a range of taping techniques which can unload the stress through the plantar fascia which can be very useful at reducing pain levels and allow normal activity levels again.

Orthotics: Orthotics are very commonly used to treat persistent plantar fasciitis as they can realign flat or high arched feet and decrease pain levels long term. Orthotics have proven to be a very successful treating option for plantar fasciitis by relieving the stress and micro tears which lead to pain development throughout the ligament.

Night splints: For the most chronic cases of plantar fasciitis a night splint may be required to provide more consistent treatment to the ligament. A night splint can provide a very good night orientated treatment option that is commonly used in conjunction with other treatments to reduce the inflammation process throughout the fascia and improve the healing process.

Alternative options such as cortisone injections, anti-inflammatories, paddings, shock wave therapy, dry needling and refexology (rare) also have their place and great potential to reduce plantar fascial pain.

About 90 percent of people with plantar fasciitis improve significantly after two months of initial treatment. However, if you don't treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity, and you may develop compensatory symptoms of the foot, knee, hip and back problems because plantar fasciitis can change the way you walk which places extra stress through these areas.

Other common forms of heel pain

Achilles tendon problems and bursitis are also common issues amongst active feet and we put a high focus on providing our patients with techniques which they can take away in order to treat themselves. As foot specialists we are very experienced at treating this type of foot pain as we see it in our foot and ankle clinic daily in elite athletes to everyday people and children.

Sever’s disease is a unique type of heel pain which can be present in children which is directly related to activity and growth spurts. This can originate as pain in itself or in conjunction with other diagnoses and the treatment options will often very due to this. It is important that this is assessed by a podiatrist as if left untreated can predispose you to permanent growth plate damage and heel pain later in life.