Heel pain (plantar fasciitis)
Plantar fasciitis (heel pain) is a very common foot problem. It usually starts as a dull, intermittent pain in the heel which may progress to a sharp, persistent pain.
The plantar fascia is a thick fibrous band on the bottom of the foot. It is attached to the heel bone and fans forward to be inserted into the bases of the toes. It acts like a bowstring to help maintain the arch of the foot.
Symptoms
Plantar fasciitis results in pain, most commonly felt in the region of the heel. The pain can, however, also be in the mid part of the arch of the foot.
Since it is difficult to rest the foot, the problem gradually becomes worse because the condition is aggravated with weight bearing.
Causes
The problem occurs when part of the inflexible fascia is repeatedly placed under tension, such as during running. It can also occur as a result of unaccustomed exercise.
Repetitive impact causes an overload that produces microscopic tears and inflammation at the point where the fascia is attached to the heel bone.
Plantar Fasciitis is a condition which subsides in approximately 95 per cent of affected people spontaneously during a 12 to 18 month period. However, it is difficult to predict how long the condition will last for each individual. The diagnosis can be confirmed with MRI or ultrasound scanning.
Treatment
Non-surgical treatment
There are many different treatment options but no actual cure for this condition. Most treatments are therefore aimed at alleviating the symptoms whilst the condition settles spontaneously.
The London Foot and Ankle Centre offers an integrated approach to treatment with a multi-disciplinary team of specialist foot and ankle consultants, podiatrists and physiotherapists. We can therefore select the treatment or combination of treatments best suited to each individual patient.
We offer the full range of treatments for plantar fasciitis, including physiotherapy, ultrasound guided injections, orthoses and taping.
We can also undertake extra corporeal shock wave therapy, a recently available treatment for long standing plantar fasciitis. Several sessions lasting only a few minutes are required.
Surgical treatment
In a very small number of cases, surgery for plantar fasciitis (heel pain) is considered for patients who have more than 12 months of persistent pain.
The operation involves the release of the plantar fascia and a small nerve which can be trapped in the region of the heel resulting in burning pain.