Heel pain can be a debilitating condition that affects individuals of all ages, impacting their daily activities and overall quality of life. At Brighton Podiatry, we specialise in the effective treatment of heel pain, adopting a holistic approach that goes beyond conventional methods. While many podiatrists often recommend orthotics as a primary solution, we recognise that cutting-edge technology and varied treatment options can successfully alleviate heel pain in most patients without relying solely on orthotic therapy.
Heel pain arises from various factors, with abnormal biomechanics, or the way individuals walk, being a common culprit. Excessive traction, or pulling on the plantar fascia, is a prevalent cause. This traction can be intensified by poorly constructed or worn-out footwear or a bruised heel. The heel bone, the largest among the 26 bones in the foot, may become a source of pain, manifesting at the front, under, on the sides, or at the back of the heel.
Heel spurs, identified through foot x-rays, are a frequently observed cause of heel pain. These bony projections are visible on the x-ray, and their presence is often associated with long bouts of Plantar Fasciitis, a condition characterised by continual pulling on the plantar fascia leading to arch pain. However, heel pain can persist even in the absence of a visible spur, a condition known as enthesopathy, often a precursor to the development of a bony spur, referred to as Heel Spur Syndrome (HSS).
We often see this sort of spur when patients are complaining of heel pain.
Xray Heel Spur
Heel pain often results from excessive pronation, commonly referred to as the "flattening of the arch." As individuals walk, the heel hits the ground first, and the center of pressure shifts to the outside of the foot, eventually moving through the large toe. Excessive pronation prevents the foot from converting into a rigid lever, causing the arch to collapse. This leads to a stretching effect on the plantar fascia, triggering an inflammatory reaction that culminates in heel pain.
Children may also experience heel pain, typically linked to growth-related factors. Inflammation of the growth plate in the heel, most common between the ages of 8 and 13, can result from increased activity. Children with heel pain often exhibit an excessive amount of pronation. At Brighton Podiatry, we frequently encounter and successfully manage such cases, ensuring children can remain active and engage in sports.
This child was in considerable pain in the heel this pain corrsponded with disruption in the growth plate.
Xray Growth Plate
Cortisone injections are a common recommendation by medical practitioners to alleviate heel pain. While this method provides temporary relief, the injection process is often painful, and the duration of relief is limited. Patients may experience recurring heel pain within a few weeks, and repeated cortisone shots can have long-term side effects on the tissue in the heel.
Numerous patients attempt various home remedies, and in some cases, these may exacerbate heel pain. Stretching, commonly employed as a home remedy, can, paradoxically, increase heel pain. Over-the-counter orthotics may also contribute to heightened pressure in the arch area, aggravating the plantar fascia and leading to increased heel pain. Extracorporeal Shock Wave Therapy (ESWT), an older treatment modality, has fallen out of favour due to its outdated nature.
Orthotics, custom-designed to suit specific foot types, can be a valuable tool in both short-term and long-term heel pain management. While orthotics can provide immediate relief for many patients, some may require them as a long-term solution. At Brighton Podiatry, our approach involves a thorough assessment of each patient's feet, allowing us to formulate personalised short-term and long-term solutions to address heel pain effectively.
Heel pain is a multifaceted condition that demands a nuanced understanding and a tailored treatment approach. Brighton Podiatry is committed to providing innovative and effective solutions, ensuring that individuals can regain the joy of pain-free movement. If you are experiencing heel pain, take the first step towards comprehensive care by visiting Brighton Podiatry – where every stride is a step closer to a pain-free life.
