Heel Pain Syndrome

What Is Heel Pain Syndrome?

Heel pain is most often caused by plantar fasciitis, a condition sometimes also called heel spur syndrome when a spur is present. Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. Other potential causes include stress fractures, tendonitis, arthritis, nerve irritation, or cysts.

Causes

• Structural foot problems (overly flat or high-arched feet)
• Inadequate arch support causing fascia inflammation
• Non-supportive footwear on hard surfaces
• Prolonged standing or jobs requiring extended time on feet
• Obesity and pregnancy-related weight gain
• Athletic overuse and sudden increases in activity

Symptoms

• Pain on the bottom of the heel
• Pain that is usually worse upon arising in the morning
• Pain that increases over a period of months
• Aching character that decreases after initial walking and stretching
• Recurrent pain after prolonged standing

Treatment Options

Non-Surgical (Initial)

• Stretching exercises targeting calf muscles
• Avoiding barefoot walking
• Ice pack application (20 minutes, several times daily)
• Activity reduction and rest
• Supportive footwear with arch support and raised heels
• Over-the-counter NSAIDs (ibuprofen)

Advanced Non-Surgical

• Shoe padding and strapping
• Custom orthotic devices
• Corticosteroid injections
• Removable walking cast immobilization
• Night splinting for extended fascia stretching
• Physical therapy
• Electro Shock Wave Therapy (ESWT)

Surgical

Surgical intervention is considered when conservative treatments fail. Dr. Ravaei will discuss available surgical options and develop an individualized treatment plan. Long-term success requires continued preventive measures including supportive footwear, stretching, and custom orthotic devices.