Plantar Fascitiis
Plantar Fasciitis is certainly the most common cause of heel pain.
There's a strand of thick skin called that connects the heel bone (the Calcaneal bone) to the toes in a fan-like pattern called the plantar fascia.
And just like tonsilitis means inflammation of the tonsils, the '-itis' suffix on the end of plantar fascia means inflammation of the Plantar fascia.
The Plantar fasciitis issue builds over time, although the pain often comes late in its development process.
The common cause is that the foot moves poorly, think flat or rolling feet. this may be subtle, i.e. only happen during walking and running, or maybe more obvious when simply standing.
However, it may happen from a pressure onto the midfoot, think runs or ladder in soft shoes, climbers pushing off an edge or simply a step onto a large stone cause the fascia to stress.
Calcaneal heel spurs, calcaneal cysts and an unstable foot/ ankle may complicate the condition's recovery. Still, regardless of the gold standard, therapy for pain relief is Extracorporeal Shock Wave Therapy.
Supportive exercises and strapping/ orthotics techniques are often used first or in conjunction with Extracorporeal Shock wave Therapy.
Tarsal Tunnel Syndrome
The tarsal tunnel can give not only pain but also numbness.
This numb feeling going into the toes as the 'tarsal tunnel' gets narrowed from poor foot movements.
This narrowing causes the nerve to get squeezes as well as the tendons causing tendonitis (tibialis posterior tendon typically) but also a nerve gets impinged/ squeezed. The heel pain condition not only creates both the tingle and pain but also the narrowing also needs release.
Bursitis
Bursa's are lubricating sacks of fluid that oil the cords of the heel.
Perplexing as it may sound even these oiling units (bursas) of the foot can be irritated. But they only truly get aggroed from very obscure events like a single strike to the foot or altered walk/ gaiting patterns.
We most often see bursitis from either tight footwear or where clients footwear is rigid. in the latter the foot within moves a lot. This culminates in a lot of rubbing causing the sacs of fluid to irritate
Heel Spurs
Heel Spurs can cause sharp stinging pain on heel strike but equally can give little to no symptoms. They are typically spikes that grow on the heel bone (calcaneal bone). As you can imagine, these can become quite uncomfortable.
They are quite annoying as they develop slightly and only give symptoms when they grow to a size where their enlargement means they take up the foot's max space.
There are two types.
- Calcific Enthesopathy (Calcific Plantar Fasciolosis)
- Calcaneal spurs (Haglungs heel or planar spurs)
The Enthesopathy type is a type of chronic Plantar Fasciitis and responds well to a therapy called ESWT (Extracorporeal Shock Wave Therapy), which we can treat very well within the practice.
The Latter (calcaneal spurs) are slightly different. Although they look similar on x-ray, they don't respond as well, and their treatment depends on the size and direction of growth to the prognosis of the condition.
X-ray analysis can be taken within the clinic to establish a prognosis if there is a suspect of heel spur pain.
