Plantar Fascitis - Heel Pain - Diagnosis & Treatment

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Dr Anurag Awasthi  Orthopaedic Specialist, Sohna Road, Gurgaon 9718112112

Heel Pain is a common disorder affecting people who generally have to walk or stand for long hours. It is also commonly seen in ladies wearing high heels. More common in Diabetics, and patients with high uric acid levels or in seronegative spondylo-arthropathies.

One of the common causes of Heel pain is Plantar Fascitis - Inflammation of the plantar fascia. Plantar fascia is attached at one end to the heel bone (Calcaneum), and the other end fans out and is attached to the base of toes.

Inflammation usually occurs due to un-due strain on the fascia, either because of the improper foot wear, or prolonged standing, excessive body weight or sometimes due to bone over growth on the undersurface of heel bone (Calcaneal spur).

Symptoms-

Patients usually complain of pain at the base of heel or deep to the heel pad. Pain gets aggravated with prolonged standing or walking. Often, the start pain on taking the first step is a typical clinical presentation.

Treatment-

1. In obese patients, the treatment starts with the efforts towards weight reduction.

2. Contrast Bath - Dipping the affected foot alternately in warm and cold water.

3. Foot wear modification such as use of soft cushion heel insoles.

4. Local Ultrasonic therapy or Interferential therapy may sometimes offer benefit; and should be tried prior to injection or surgery.

5. Local Steroid injections provide short term relief; blood sugar estimation is mandatory before steroid injections. Does not produce systemic side effects. May be repeated every 4-6 months for 3-4 times.

6. Surgery- In patients not responding to the above treatment, and those with a large Calcaneal spur, the bony overgrowth may be surgically removed.

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