The most common cause of heel pain.
Cause: There is a ligament in the sole of the foot that connects the heel bone to the toes (plantar fascia) and thus plays an important role in maintaining the arch of the foot. If for any reason this ligament is stretched and damaged (strain), it will lead to inflammation, swelling and weakness in this ligament, and then it will be painful, especially when standing, when the pressure on the ligament increases.
According to the explanations given below, in the cases where the pressure on this ligament increases, it is more likely to occur • Flat feet or excessive arching of the feet
• Walking, standing or running for long periods of time
• Overweight
• Inflexibility of calf muscle or Achilles tendon
Symptoms: The feeling of pain in the heel, especially in the morning when waking up, is more intense than ever, and the patient has to walk on his toes for a while. Of course, with the passage of time and the start of activity, the intensity of the pain gradually decreases. Also, after a period of immobility such as sitting, the pain becomes severe again when starting to move.
Diagnosis: It is given based on physical examination and disease history. It should be noted that what is sometimes shown to patients as a heel spur in the radiology image (bony prominence at the bottom of the heel bone) has nothing to do with it and may also be seen in the radiology image of a healthy person. In fact, it is the cause of inflammation in the plantar ligament, which cannot be seen in the radiology picture. Of course, radiology may be requested to rule out other possible causes of heel pain.
Treatment: • Avoiding activities that aggravate pain, such as standing for long periods of time or walking for long periods, especially on hard surfaces.
• Use of appropriate medical shoes and insoles.
• Using different modalities of physiotherapy such as ultrasound or shock wave
•Performing appropriate exercises to increase the flexibility of the calf muscles and the Achilles tendon.
• Weight Loss
• Anti-inflammatory drugs such as NSAIDs
• Steroid injection around the injured ligament.
It should be noted that after the treatment, if the causative factors are not avoided, the symptoms may return.
Author: Dr. Hossein Arjamand