Millions of Americans suffer from painful heel syndrome every year. It’s one of the most disabling foot conditions routinely seen by clinicians in orthopedic clinics across the country and can be a real challenge to deal with if not done so quickly.
Painful heel syndrome, also known as plantar fasciitis, is diagnosed clinically by using a series of physical tests and by obtaining a thorough patient history. The natural history of the disorder is typically able to provide insight into both the diagnosis and a proper course of treatment.
Yet, for such a common occurrence, there are few medical interventions that work as well as a conservative physical therapy approach. Anti-inflammatory drugs such as ibuprofen and cortisone injections have been proven to have limited – if any – capability to remedy the problem.
If your heels hurt and you suspect that plantar fasciitis may be the culprit, read on to see some of the common signs and symptoms that can assist you in diagnostic process.
If the first few steps after being sedentary are painful, you may have plantar fasciitis. Initiation pain is a hallmark feature of plantar fasciitis and is usually worst in the morning when rising from bed. It can be so bad, some patients are actually afraid to step on their feet because of impending pain.
If you poke your heel and it sends you through the roof, you’ve almost certainly ruled in plantar fasciitis. Extremely intolerant of direct pressure, the plantar fascia will sing like the morning birds when stimulated.
If you have stiff or bad ankles they could be contributing to poor foot mechanics, thus causing fasciitis. Improper bending limits at the foot and ankle can rapidly and almost certainly predispose you to developing a painful heel. So if you’ve had significant ankle problems in the past, it may be time for you to be checked out by a foot specialist.
If you stand on your feet for more than eight hours per day you’re at risk. Prolonged weight-bearing time has been associated with development of plantar fasciitis. If this is the case, make every attempt to get off your feet when possible.
If you have a limp and walk on your toes or the outside of the foot, it’s a sign that you’re trying to avoid direct contact over the plantar fascia. Loaded with nerve endings, any direct compression will yield substantial discomfort in the heel. So if your walking seems a bit funny or if someone has asked you why you’re limping, it’s time to see the doc.
If stretching provides temporary relief, you likely need a customized program. Generally, plantar fasciitis responds excellently to manual medicine. Physical and massage therapists, podiatrists and athletic trainers are all well versed in mitigating pain through stretching – so stretch out under supervision.
Epidemiology studies indicate that 80 percent of plantar fasciitis cases have a natural life of six to 18 months if left untreated. Twenty percent, however, will become chronic and can last indefinitely.
Don’t wait too long to be seen; the longer you have the harder it can be to chase away. If you have any of the previously mentioned signs or symptoms, have your foot examined by a trusted clinician.
Gloucester resident Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes “On the Mend” weekly. Questions may be submitted by email to joedivincenzo@comcast.net.
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