Halting Heel Pain: Treating Plantar Fasciitis and Heel Spurs

If you’ve found yourself barely able to walk upon arising from bed or after sitting for a time because of pain in the heel that feels like walking on sharp stones, you may have plantar fasciitis or its more serious cousin, heel spurs.

Plantar fasciitis is the most common form of heel pain and affects almost two million people in the United States per year. It occurs when the connective tissue of the plantar ligament stretches irregularly and then tears. The result is inflammation in the long plantar ligament that transverses the bottom of the foot from toes to heel. The burning, stabbing or aching pain usually occurs at the attachment to the heel bone, called the calcaneus, and gets worse with both disuse or prolonged use as the ligament either relaxes or becomes overly stressed. You can reproduce the pain by dorsiflexing (pulling up) the toes.

The good news is that plantar fasciitis rarely requires surgery to correct. The bad news is that ligament tears heal slowly and that the situation that caused the initial tear, if continued or repeated, can slow down the healing process.

Improper gait and genetic foot problems like flat feet, very high arches, pronation and supination can cause plantar fasciitis as can certain repetitive activities. Athletes and folks taking up a new physical activity are particularly prone to plantar ligament tears. Proper exercise shoes and good form are a must to prevent injury. In fact, good shoes that support your feet are your number one defense. See a professional who can help you choose the best brand or insert for your particular gait. You will likely need to change the insert before the outer sole is worn out. Innersoles have a woefully short life in relation to their cost.

Age and age-related illness are also a factor in developing plantar fasciitis. Arthritis sufferers are prone to heel pain, and those with diabetes not only get plantar fasciitis more frequently but may not heal as quickly from micro-tears in the ligaments. Being overweight can also damage the plantar ligament, no matter what your age, and pregnant women are prone to the ailment both because of the weight-gain and because hormones during pregnancy cause the connective tissue to relax in preparation for the stretching of the pelvis during the birth process.

The first treatment for heel pain is rest, ice, and elevation. Many folks say rolling the foot across a plastic bottle filled with frozen water is a great relief. OTC pain relievers can also help. If you think your foot gear may be the cause, buy new, better supporting shoes. In fact, spending a little extra on good foot support now may prevent your ever getting plantar fasciitis. Ask anyone who suffers from it if good shoes are worth the money.

Massage can help stretch the plantar ligament, and your massage therapist has been trained to gently stretch the ligament without tearing it further. If your therapist can do Medicupping, that may help gently release the tendons. Many chiropractors can perform adjustments to the feet that relieve the pressure. Obviously, if first-aid treatments and manipulation by your massage therapist and chiropractor do not work, you need to see a doctor or podiatrist who may prescribe orthotics to take the pressure off the ligament. Failing that, they may prescribe corticosteroid injections or a new sonar treatment called extracorporeal shock wave therapy. The most extreme treatment is surgery.

Heel spurs are bony fragments that extend fromt he calcaneus into the soft tissue of the heel. They often occur when plantar fasciitis is untreated, causing prolonged pulling of the inflammed ligament on the bone. However, bone spurs can occur on their own. Early treatment is the same as for plantar fasciitis, but surgery is sometimes the only option to remove a bone spur.

Preventing plantar fasciitis in the first place should be a part of your self-care practice. First, keep your weight down to reduce tension on the plantar fascia. Second, wear shoes that cushion and support the heel, ball, and arch of your foot, and replace old-worn-out shoes that have lost their support as they may actually be the cause of the irregular plantar stretching and tears. You should wear shoes on hard surfaces rather than going barefoot or wearing cheap flip-flops. Watch repetitive activities and build up your endurance in new sports. Finally, stretch the calf muscles, your Achilles tendons and your feet regularly and before any exercise to keep them flexible and pain-free. Have your massage therapist work your feet and calves more fully if you feel a problem developing.