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Do You Suffer from Sore Heels?

Feet in Sand

If you experience painful aching in your heels, particularly in the morning, you could be suffering from Plantar Fasciitis.

This condition is most common in active people aged from 40 to 70 who spend a lot of time on their feet. Usually, the sufferer can take part in activities without direct pain but will feel discomfort afterwards. The pain may feel like you have a bad bruise on the base of the heel or present as a sharp, stabbing pain in any part of the heel.

What causes this condition?

The plantar fascia is a soft tissue structure which runs along the sole of the foot from the heel (calcaneus) to the base of the toes. Plantar fasciitis occurs when the plantar fascia becomes inflamed or thickened due to damage or injury.

So, what might cause such inflammation or thickening?

Often an increase in activity such as starting a health kick or changing jobs, that may involve more standing or extra walking, can trigger the condition. Sometimes new or inappropriate shoes teamed with a moderate increase in activity can aggravate the plantar fascia. Tight calves and/or abnormal biomechanics can also play a part in this condition taking hold.

Why does it hurt most in the morning?

The inflammation or damage may heal (via fibrosis or scar tissue formation) if you are off your feet overnight. However, if your foot isn’t getting sufficient time to fully repair, then the new tissue can be damaged again as soon as you resume activity the following morning. And so, the cycle continues…

How is this condition diagnosed?

After discussing your symptoms and activity levels, a podiatrist would thoroughly examine your feet and lower legs. Your gait would also be reviewed to further understand your movement patterns. Sometimes imaging is performed but this is usually to rule out other conditions.

What is the treatment for Plantar Fasciitis?

Treatment of plantar fasciitis could include such strategies as:

  1. Physical therapy (stretching and strengthening exercises),
  2. ice and heat massage,
  3. taping and splints,
  4. orthotics,

A fifth strategy, Extracorporeal Shock Wave Therapy (ESWT), can be used on patients who have had persistent Plantar Fasciitis or have tried the conservative therapies (as listed above) without significant results.

What exactly is Extracorporeal Shock Wave Therapy (ESWT)?

Extracorporeal Shock Wave Therapy is a non-surgical treatment option that provides fast relief and mobility restoration. The treatment works on a number of levels. It reduces pain by inhibiting a neurotransmitter associated with pain, it promotes blood flow which helps repair damaged tissue and also stimulates the body's immune system to accelerate healing.

What does 'Shockwave Therapy' feel like and how quickly do you recover?

Most patients say treatment feels like small pulses against the skin. If the treatment area is already tender, then some discomfort is likely. Treatment normally takes 4-5 minutes so this discomfort is tolerable.

Immediately after treatment patients can feel some numbness or heaviness in the area. Many patients feel an immediate reduction in pain but sometimes soreness can increase over the following 12 hours. If required, a combination of icing the area and paracetamol are the best pain treatments.

It is recommended that patients rest the foot for 2-3 days following the therapy. Patients can return to non-physical work over this period, although exercise needs to be limited.

In Summary

  • Plantar fasciitis occurs when the plantar fascia becomes inflamed or thickened due to damage or injury
  • An increase in activity often triggers the condition
  • Pain is normally worst in the morning or after a prolonged rest period
  • There are numerous non-surgical treatment options
  • Extracorporeal Shock Wave Therapy is a highly-effective treatment if other conservative treatment options are unsuccessful

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