Common causes

• Plantar Fasciitis

Rarer causes

• Arthritis in the heel (subtalar joint)

• Fracture of the heel Bone (calcanium)

• Irritation of the nerves on the inside of the heel

Why does this occur?

There are many factors that can contribute to the formation of Plantar Fasciitis. It is common in people who spend all day on their feet or who are overweight. Stiffness of the ankle or tightness of the Achilles tendon can increase the stresses on the heel, people who have high arched feet, or flat feet are less able to absorb the stress of walking or sometimes it can start after an injury to the heel.

Other rare causes include systemic diseases such as rheumatoid arthritis or rheumatoid type conditions.

Symptoms

Well-localised pain in the heel, worse on weight bearing.

Investigations

Full clinical examination would be required. X-rays would be required to identify any associated conditions.

Non-operative treatment

Non-operative treatment consists of appropriate footwear, a soft heel pad is useful to wear as a shock absorber, physiotherapy, anti-inflammatory medication, possibly the use of a night splint, possibly the use of a steroid (anti-inflammatory) injections, possibly other pain control treatments such as Transcutaneous Nerve Stimulation (TENS) or acupuncture. 

Operative treatment

It is exceedingly rare to need an operation for heel pain. This would be discussed with your clinicians.