The heels withstand a substantial amount of the pressure when we stand and walk, and pain in the heel region can occur for many reasons. Some of the most common include arthritis, heel bursitis, heel spurs and plantar fasciitis, a condition that occurs when the strong band of fibrous tissue that helps support the arch becomes inflamed and irritated.
Plantar fasciitis becomes much more common with age as wear and tear from years of standing and walking take their toll on the connective tissues that support the foot. People who are overweight or obese and women who are pregnant are also more likely to experience plantar fasciitis, and so are athletes whose feet and heels are subjected to repeated forceful pressure. Less commonly, the plantar fascia may become injured. Pain associated with plantar fasciitis is more pronounced when waking up or after a long period of sitting, decreasing as the foot is used and then returning again after another period of inactivity.
First, the foot and ankle will be carefully evaluated to determine the cause of pain. In some cases, diagnostic imaging may also be ordered to look for underlying issues that could be causing symptoms. Often, pain can be managed with custom orthotics, special supports worn inside the shoes to reduce pressure and distribute weight more evenly. Special splints or braces may be used to gently stretch the plantar fascia so inflammation is reduced and the tissue becomes more flexible. Oral medications and injections of corticosteroids may also be used to reduce pain and inflammation. Lifestyle changes like losing excess weight or improving posture or gait mechanics may also help. When these conservative approaches fail to provide relief, surgery may be necessary to remove bone spurs, reposition the plantar fascia or address other issues.