Plantar fasciitis
Most commonly, heel pain is caused by plantar
fasciitis, an inflammation
of the fibrous tissue (plantar fascia) along the
bottom of your foot that connects your heel bone (calcaneus)
to your toes.
The plantar fascia acts like a shock-absorbing
bowstring, supporting the arch in your foot.
However, if tension on that bowstring becomes too
great, minute tears can occur along with
inflammation. The result is a stabbing or burning
pain that's usually worse in the morning because the
fascia tightens (contracts) overnight. Once your
foot limbers up, the pain generally decreases, but
it may return after long periods of standing or
after getting up from a seated position. In severe
instances, your foot may hurt with the slightest
pressure, making walking difficult. Sometimes,
plantar fasciitis is also associated with a growth
(bone spur) that develops from tension on your heel
bone.
When to seek medical advice
Inspect your feet
on a regular basis so that you're aware of new symptoms, such as
swelling or bruising.
If you experience
pain and see little progress after a month of home treatment, seek help
from your family doctor, a foot doctor (podiatrist) or a doctor who
specializes in the treatment of muscle and bone problems. Seek help
sooner if your pain worsens, despite home treatment. If you have
diabetes or another condition that causes poor circulation, see your
doctor for an early evaluation of any changes in your feet.
Screening and diagnosis
Your doctor will
ask if the pain is constant or occurs only when you put weight on your
heel. An X-ray of your heel bone may rule out a stress fracture.
However, a stress fracture often isn't apparent on an X-ray for up to
four to six weeks after an injury. If your doctor suspects an acute
stress fracture, a magnetic resonance imaging (MRI) scan or bone scan
may be necessary.
Sometimes, an
X-ray shows a spur of the bone projecting forward from the heel bone. In
the past, bone spurs were often blamed for heel pain and removed
surgically, but doctors have found that they're typically not the cause
of pain. Surgery to remove spurs is rare.
Complications
Ignoring plantar
fasciitis may result in a chronic condition that hinders your regular
activities. You may also develop foot, knee, hip or back problems
because of the way plantar fasciitis changes your walking motion.
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