Heel pain is common in adults, with most people likely to have heel pain develop at some point in their lives. Treatment is very successful, as long as the right combination of therapies is used. Many people choose to be treated initially by their family doctor instead of going straight to a foot specialist (podiatric physician). This article will discuss the advantages of seeking a podiatrist first for care of this condition, as well as impediments to reaching a foot specialist for initial treatment.
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Heel pain is nearly always related to injury to a ligament called the plantar fascia. This thick, rubbery band of tissue begins in the heel and runs to the ball of the foot within the arch, and is separated into three bands. A wide variety of situations can cause injury to this fascia, but by far and away the most common cause is chronic damage to the tissue because of abnormal foot structure. Most people with this condition have flat or flexibly flattening feet that stretch and strain the fascia with every step taken. Over time, and with the right conditions, the fascia attachment at or near the heel bone can become inflamed and thickened, with microscopic tearing upon arising from bed and from a seated position, or after standing or moving for a lengthy period of the time. The infamous heel spur is related to this strain. While heel spurs are rarely ever the source of pain (despite the common myth they cause heel pain), they do form benignly as a result of the strain on the outer layer of the heel bone connected to the fascia.
High arches cause plantar fasciitis and heel pain due to poor shock absorption in the foot from a lack of flattening ability. The fascia becomes inflamed as a result of this constant shock. High arches are seen less frequently than flat arches, and therefore high arch related foot pain is seen less commonly. People with ‘normal’ arches can still develop plantar fasciitis from straining injuries. This can occur when ladders or stairs are used in excess, when one steps on a blunt object, or during athletic activity such as running sports.