Getting to the Root of Heel Pain

A debilitating condition for many patients, heel pain impacts nearly 2 million Americans.  The pain often strikes from the moment they get out of bed and stays with them throughout the day.

The National Institute of Health states heel pain is not often caused by the result of a single injury but the result of excessive or repetitive heel pounding.  Heel pain is commonly associated with plantar fasciitis. But many of those diagnosed with plantar fasciitis may have a different issue.

According to foot and ankle expert, Josh Bailey, PT, DPT, OCS, CSCS, CPed only 10 to 15 percent of the patients diagnosed with plantar fasciitis actually have the condition.  Many of those diagnosed with plantar fasciitis actually have one of 72 conditions that produce heel pain similar to plantar fasciitis.  Each condition requires a different method of treatment.   

Plantar fasciitis is caused by inflammation of the thick connective tissue connecting the heel to the sole of the foot. The pain is often worse in the morning due to the foot becoming stiff overnight and pain is often felt in arch instead of the heel. 

Another common cause of heel pain is heel pain syndrome. This condition is more chronic in nature and forms over years.  Unlike plantar fasciitis, it is not caused by inflammation. Rolling the foot over an ice bottle can be beneficial for those with true plantar fasciitis and do nothing for a patient with heel pain syndrome.

Since treatment for each diagnosis are different, Dr. Bailey encourages physical therapists to take the time to do their own evaluation when a patient walks into their clinic with a plantar fasciitis diagnosis.  He suggests investigating the reasons why the pain developed.  Is the pain due to abnormal use of a shoe, biomechanical limitations or recent stress on the foot?  Does the pain increase when a patient extends his toes? If so, the pain is likely caused by plantar fasciitis. If not, another condition may be causing the pain. 

True plantar fasciitis will heal regardless of treatment. Dr. Bailey states some patients recover on their own in as little as 6 months while others take 3 years before symptoms go away.  A physical therapist can help speed the recovery. Many patients often see a significant reduction in their symptoms within 6 visits. 

Since heel pain syndrome is more chronic in nature, a physical therapist can help reduce the pain and symptoms associated with the condition.  

Learn more ways to effectively address heel pain by listening to the PT Talker podcast featuring Joshua Bailey, PT, DPT, OCS, CSCS, CPed, co-owner, president and chief clinical officer for Rehabilitation Associates of Central Virginia.

Click here for more information on PT Talker.