Plantar Heel Pain

 What we’re going to talk about today is a condition known as plantar heel pain syndrome. More correctly a combination of different conditions that result in pain underneath the plantar aspect of the heel here. The main cause of plantar heel pain syndrome is plantar fasciitis. This is a condition that is typified by the presentation of rapid onset pain underneath the plantar heel area, often first thing in the morning, or when you raise from a non weight bearing to a weight bearing situation.

I think the important thing to remember is that it probably makes up about 70% of plantar heel pain, which is not 100%. And the important thing to note is that other conditions can also produce pain underneath the heel. Such things as fat pad atrophy, heel trauma, enthesopathy or traction type problems as far as the insertion, often associated with things like rheumatoid arthritis can often mimic types of plantar facial pain. There are also plantar facial ruptures and tears, as well as things like heel spurs. All of these can and do contribute to plantar heel pain, as well as mechanical overloading of the heel.

Once a specific diagnosis has been made, this may include some form of imaging to confirm the diagnosis, but not always. Once the diagnosis is clarified, and the clinician is happy with the diagnosis, then they can move on to a specific treatment regime for you. Now, the interesting thing about these sorts of conditions is that they are not static entities, they don’t just occur and stay the same throughout the full duration of the problem.

Plantar fasciitis can and often is present for a considerable period of time, say 12 months to 18 months in some cases. What I have noticed over the last 20 years is that the presentation of the pain tends to change depending on the degree or on the nature of the problem at the time. That means it can go from a very acute and sharp symptomatic problem that is involved with pain first thing in the morning, to a more dull, aching throbbing sort of sensation that is usually more painful in the afternoon when standing on your feet for prolonged periods of time, that is more typical of a chronic type of problem. And as with most of these problems involving feet, the way that you walk to offload the painful area often is implicated in causing pain and problems in other areas.

We will talk about this a little more later, but if you have any heel pain, please do come in and see us at Waikato Podiatry Clinic. We are freeing you from foot and leg pain so you can live an active and healthy life.

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