Heel pain is by far the most common foot problem in adults, especially females, says podiatrist Christian Ellul. He takes a look at the various causes and possible treatments.

Heel pain is by far the commonest foot problem in adults affecting all ages, particularly females.

The most common cause of heel pain in adults is plantar fasciitis, which is an inflammation of the band of tissue in the sole that connects the heel to the toes and forms the natural foot arch.

Plantar fasciitis may or may not be complicated by a calcaneal spur, a small bone growth that protrudes out of the heel.

Plantar fasciitis may also be referred to as plantar fasciosis. In contrast to fasciitis, which essentially means inflammation, fasciosis refers to degeneration of the tissue. In fact, if left untreated, acute plantar fasciitis may develop into a chronic painful condition, which results in slow and irreversible degeneration of the fascia, hence plantar fasciosis.

The location of the pain is usually exactly under the heel but may also occur in the arch of the foot

Pain typical to plantar fasciitis is that which feels worse when arising on to your feet such as in mornings or after sitting down for a while, and usually progresses in severity when left untreated.

The location of the pain is usually exactly under the heel but may also occur in the arch of the foot.

Before one highlights the available treatments for plantar fasciitis one has to understand the cause of this condition.

Plantar fasciitis may or may not be complicated by a calcaneal spur, a small bone growth that protrudes out of the heel.

Unfortunately, it is often the case that patients are given repetitive anti-inflammatory medications and corticosteroid injections when the foot structure itself, the principal cause of this condition, has not been evaluated.

In fact, it is people who excessively pronate (inward rolling of the foot while walking) and those with either a low arch (flat foot) or high arch, who are prone to developing this condition.

The reason why this condition is more prevalent in females is due to footwear. Excessive high heels, flip-flops and non-supportive footwear exacerbates this condition.

A biomechanical exam by your podiatrist will help reveal these abnormalities and in turn resolve the cause of plantar fasciitis. By addressing this cause, the patient can be offered a podiatric long-term solution to his problem.

Once diagnosed, treatment for plantar fasciitis may include one or more of the following: advice on footwear, in particular use of arch-supportive footwear; avoid walking barefoot; stretching exercises; shoe modifications such as heel pads, taping and strapping, anti-inflammatories and orthotic devices to correct abnormal foot mechanics.

Injection therapy with corticosteroids is only advisable if all the conservative treatment methods mentioned above have been exhausted due to undesired effects implicated with steroid infusion in the heels.

Christian Ellul is a state-registered podiatrist and president of the Association of Podiatrists of Malta.

president@podiatry.org.mt