The most common cause of pain in the heel is a condition called Plantar Fascitis.

 Plantar refers to the bottom surface of the foot.  Fascia refers to a dense strong connective tissue layer or ligament that covers the bottom of the foot.  It grows out of the heel bone and inserts in the bases or beginnings of the toe bones.  There is fat between this ligamant and the skin, and there is muscle structure that is found between it and the foot bones.  Itis is the medical word that means inflammation.  Now you can understand that Plantar Fascitis means inflammation of the ligament that is in the bottom of the foot and goes from heel bone to toe bones.  In way of a little further explanation, connective tissue that hooks a muscle to a bone is a tendon, and one that connects bone to bone is a ligament.

 This Plantar Fascia usually gets sore and painful, inflamed, where it inserts into the heel bone.

 We think this tissue gets tiny tears in it from repetitive trauma, such as walking on harder surfaces, or running.  When these tears happen over and over the area eventually gets sore and painful, or inflamed.  Being overweight is a strong risk factor for this condition.  Wearing footwear that does not provide good arch support may also make the condition more likely.  There are much less common causes of heel pain but by far Plantar Fascitis is the most common cause.

 The heel area usually hurts when you first walk on it in the morning and anytime that you have walked on it alot.

 It is thought that many heel spurs may be a result of the chronic inflammation of Plantar Fascitis.  A heel spur is an overgrowth of bone which forms a point coming off the front bottom of the heel bone where the plantar fascia starts.

 Most times this condition will resolve with treatment utilizing most or all of the following things, but may take many, many months.

• anti-inflammatory medications
• quality shoes
• night splints
• stretching exercises
• heel pads or other inserts
• decrease in offending activity
• steroid injections

 In some locations, shock wave therapy may be available and has shown to be helpful.  Rarely surgery is necessary.

 Written by:  Michael Beasley M.D.