Heel Pain (Plantar Fasciitis)

Heel pain is the most common problem foot doctors see. There are many different ailments that can cause heel pain, but the most common is plantar fasciitis. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely a bone cyst.

What is Plantar Fasciitis?

Plantar fasciitis is the term commonly used by most people to refer to heel pain and arch pain on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called the plantar fascia, that stretches from the heel bone across the arch to the base of the toes.

Causes

Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, which lengthens the arch, and puts added tension on the plantar fascia. Repetitive microtrauma causes inflammation.

Symptoms

• Pain is worse first step in the morning or after rest
• Pain on the bottom of the heel
• Pain in the arch of the foot
• Pain that increases after standing or walking for long periods

Diagnosis

To arrive at a diagnosis, the foot doctor will obtain your medical history and examine your foot. Throughout this process the doctor rules out all the possible causes for your heel pain other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis or heel spur syndrome.