Heel Pain (Part One)

Plantar Fasciitis and Heel Spur or Epicalcaneal Bursitis

Plantar fasciitis is the most common cause of pain in the bottom part of the heel. About 2 million patients are treated for this condition every year.

Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed.

Anatomy

The plantar fascia, the band of the foot, is a long thin ligament that stretches directly under the skin on the bottom of your foot. It connects your heel to the front of your foot and supports the arch of your foot.

Causes

The plantar fascia is designed to absorb high stresses and strains as we walk. However, sometimes, too much pressure damages or tears the fascia. The body's natural response to injury is inflammation, which results in heel pain and stiffness of the plantar fascia.

Risk Factors

In most cases, plantar fasciitis develops without a specific, identifiable reason. However, there are many factors that can make you more prone to the condition:

• Tighter, strained calf muscles making it difficult to flex your foot and bring your toes toward your shin
• Obesity
• Very high arch
• Repetitive impact activity (Running)
• New activity or increase in activity

Heel Spurs – Epicalcaneal Bursitis - Heel Spur

Although many people with plantar fasciitis have heel spurs, the spur is not necessarily the cause of the pain in plantar fasciitis. One in 10 people has a heel spur, but only one in 20 (5%) people with a heel spur experiences pain in the heel. Because the heel spur is not the cause of plantar fasciitis, consequently the pain can be treated without removing the heel spur.

The epicalcaneal spur does not cause heel pain from plantar fasciitis

Symptoms

The most common symptoms of plantar fasciitis include:

• Pain in the bottom of the foot near the heel
• Pain with the first few steps after getting out of bed in the morning, or after a long period of rest, such as after a long drive. The pain subsides after a few minutes of walking.
• Significant pain after (not during) exercise or activity.