Understanding Plantar Heel Pain
While plantar fasciitis is one of the most common causes of heel pain, it is not the only condition that can lead to discomfort in this area. As a functional medicine podiatrist, it’s essential to consider a holistic view of the patient’s health to identify other potential causes of plantar heel pain. In this blog post, we’ll explore several other conditions that might be contributing to your discomfort.
1. Bursitis
What Is Bursitis?
Bursitis involves inflammation of the bursa, a small fluid-filled sac that cushions and lubricates areas where muscles, tendons, and bones rub against each other. In the heel, this condition is often due to overuse or repetitive strain.
Symptoms
Pain and tenderness in the central plantar heel
Swelling and redness
Increased pain with movement, standing, or pressure
Treatment
Rest and ice
Anti-inflammatory medications
Proper footwear
Inserts with a cut-out for the bursa
Steriod injection
2. Tarsal Tunnel Syndrome
What Is Tarsal Tunnel Syndrome?
Tarsal tunnel syndrome is caused by compression of the posterior tibial nerve as it passes through the tarsal tunnel, a narrow space inside the ankle. This condition can lead to pain and numbness in the heel and the bottom of the foot.
Symptoms
Burning or tingling sensation in the heel and foot
Pain worse at the end of the day
Pain with prolonged standing
Pain that radiates from the inside of the ankle
Numbness or a "pins and needles" feeling in the arch that may extend to the toes
Treatment
Anti-inflammatory medications topically
Laser therapy
Orthotics to support the arch
In severe cases, surgical intervention
3. Sever’s Disease
What Is Sever’s Disease?
Sever’s disease, or calcaneal apophysitis, is a common cause of heel pain in growing children and adolescents. It occurs due to inflammation of the growth plate in the heel.
Symptoms
Pain in the back or bottom of the heel with activity
Pain with manual compression of the heel
Swelling and redness
Pain that worsens with physical activity
Treatment
Rest and ice
Shockwave therapy
Tapain
Stretching exercises for the Achilles tendon and calf muscles
Proper footwear with good heel support
Avoiding high-impact activities
4. Achilles Tendinitis
What Is Achilles Tendinitis?
Achilles tendinitis involves inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. Overuse or sudden increases in physical activity can lead to this condition.
Symptoms
Pain and stiffness along the Achilles tendon
Pain that worsens with activity
Swelling and tenderness
Treatment
Rest and ice
Shockwave, laser, taping
Stretching and strengthening exercises
Proper footwear and orthotics
Anti-inflammatory medications
5. Fat Pad Atrophy
What Is Fat Pad Atrophy?
The fat pad under the heel acts as a natural cushion, absorbing shock and reducing pressure. Over time, this fat pad can thin out, leading to heel pain.
Symptoms
Deep, aching pain in the heel
Pain that worsens with prolonged standing or walking
Treatment
Cushioned insoles or heel cups
Proper footwear with good shock absorption
Reducing high-impact activities
Fat pad injections
6. Stress Fractures
What Are Stress Fractures?
Stress fractures are small cracks in the heel bone caused by repetitive stress or overuse. They are common in athletes and individuals who engage in high-impact activities.
Symptoms
Gradual onset of heel pain
Pain that worsens with activity and improves with rest
Swelling and tenderness
Pain with manual compression of the heel
Treatment
Immobilization
Rest and avoid weight-bearing activities
Shockwave
Ice therapy
Proper footwear
7. Plantar Fascial Rupture
What Is Plantar Fascial Rupture?
A plantar fascial rupture is a tear in the plantar fascia, which can occur suddenly due to trauma or gradually from chronic overuse.
Symptoms
Sudden, intense pain in the heel or arch
Swelling and bruising
Difficulty walking or bearing weight on the affected foot
Treatment
Rest and ice
Immobilization with a cam walker boot or cast
Physical therapy for rehabilitation
Plantar heel pain can result from various conditions, not just plantar fasciitis. Understanding these different causes is crucial for accurate diagnosis and effective treatment. As a functional medicine podiatrist, I emphasize a comprehensive approach to treating heel pain, considering all possible contributing factors to develop a personalized treatment plan. If you’re experiencing persistent heel pain, it’s important to consult with a healthcare professional to determine the underlying cause and receive appropriate care.
For more information or to schedule an appointment, contact Lighthouse Foot and Ankle Center in Scarborough, Maine at 207-774-0028 or visit our website at www.lighthousefootandankle.com.