Heel Pain and Plantar Fasciitis Treatment

Heel Pain & Plantar Fasciitis Specialists in Waxahachie, Corsicana & Ennis

Heel pain is one of the most common foot problems we treat at Family Foot & Ankle Centers. Plantar fasciitis is a frequent cause of heel pain, but several other conditions can produce similar symptoms. Determining the cause of your heel pain is an important first step in choosing the appropriate treatment.

Our podiatrists evaluate and treat heel pain at our Waxahachie, Corsicana and Ennis offices. Treatment is based on your symptoms, examination findings and individual condition, with both conservative and advanced treatment options available when appropriate.

What Are the Symptoms of Plantar Fasciitis?

Plantar fasciitis commonly causes pain near the bottom of the heel. One of the most characteristic symptoms is sharp heel pain with the first few steps after getting out of bed in the morning or after sitting for an extended period.

The pain may improve after walking for a few minutes as the plantar fascia begins to loosen, but it can return after prolonged standing, walking or other activity. Some patients also experience tenderness along the bottom of the heel or arch.

Because other conditions can cause similar heel pain, persistent or worsening symptoms should be evaluated to determine the underlying cause and appropriate treatment.

What Causes Plantar Fasciitis?

Plantar fasciitis heel pain is caused by a muscle imbalance in the foot and lower leg. This can allow the arch to flatten too much or not flatten enough. Both of these put too much strain on the ligament that attaches into the heel and supports the bottom of the foot. This commonly strained ligament is called the “plantar fascia” and when it becomes inflamed it is called plantar fasciitis. When this ligament becomes strained and inflamed it causes sharp pain. Pain is normally relieved with rest but returns as soon as the person returns to walking.

Why Does My Heel Hurt in The Morning?

Morning heel pain is one of the classic symptoms of plantar fasciitis. The plantar fascia is a strong band of connective tissue that runs along the bottom of the foot and helps support the arch. While you sleep or rest for an extended period, the plantar fascia and surrounding tissues can tighten.

When you first stand up, your body weight suddenly stretches the irritated plantar fascia. This can cause sharp pain at the bottom of the heel, particularly during the first several steps of the morning. As you continue walking, the tissue gradually loosens and the pain may decrease.

Heel pain that improves after a few steps but returns after prolonged sitting, standing or activity is commonly associated with plantar fasciitis. However, other conditions can cause similar symptoms, so an examination is important when heel pain persists.

Why does it often get better after walking several steps?

After several steps, the plantar fascia becomes more flexible and begins to loosen.  This takes some of the tension off the plantar fascia and pain is usually reduced.  The pain is not eliminated but it is often better than those initial first steps out of bed or getting off the couch.

Why is stretching so important for heel pain plantar fasciitis?

One of the first things our doctors will discuss with you is one of the simplest treatments for heel pain. Stretching the plantar fascia before putting the foot on the floor after resting is very important. Pulling the toes back toward the shin and/or doing a plantar-fascia-specific stretch for 30 seconds several times can gradually loosen the fascia before body weight hits it.

Does a night splint work for plantar fasciitis?

A night splint works on the same principle as stretching: it help keep the plantar fascia from tightening excessively while at rest. This keeps the fascia from spending the entire night in a shortened position. This can help reduce first step pain considerably.

What are Other Causes of Heel Pain?

Although plantar fasciitis is a common cause of heel pain, several other conditions can cause pain in or around the heel. The location of the pain, how it began and what activities make it worse can help your podiatrist determine the underlying cause.

Heel spurs. Heel spurs are bony growths that can develop on the heel bone over time, often in association with chronic strain on the plantar fascia. Heel spurs do not always cause pain, and many people have them without symptoms.

Heel bursitis. Bursae are small, fluid-filled sacs that help cushion areas where tissues move over bone. When a bursa near the heel becomes irritated or inflamed, it can cause localized pain, tenderness and swelling.

Achilles tendinitis. Pain at the back of the heel may result from irritation or inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. Symptoms may be aggravated by walking, running or other activities.

Stress fractures. Repetitive stress on the heel bone can sometimes cause a small fracture. Heel pain from a stress fracture may become progressively worse with weight-bearing activity and requires proper evaluation.

Heel pad irritation or bruising. The fatty tissue beneath the heel helps absorb shock. Repetitive impact or direct trauma can irritate or bruise this area and cause pain when standing or walking.

Bone bruise. Your heel bone itself can become bruised and painful if your heel strikes something hard. Many people refer to this as a “stone bruise”.  Pain can be sharp and stabbing when walking or even dull and aching. This can mimic plantar fasciitis heel pain but unlike with plantar fasciits, most people remember what caused their heel bruise. 

Getting the Right Diagnosis for Heel Pain

Heel pain can have several possible causes, and different conditions can produce similar symptoms. An accurate diagnosis is important because the appropriate treatment depends on what is actually causing your pain.

At Family Foot & Ankle Centers, our podiatrists evaluate your symptoms, medical history and examination findings to determine the likely source of your heel pain. When appropriate, digital X-rays, diagnostic ultrasound or other testing may be used to help evaluate the heel and surrounding structures.

How is Heel Pain Treated?

Treatment for heel pain depends on the underlying cause, the severity of your symptoms and how long the problem has been present. At Family Foot & Ankle Centers, treatment is tailored to each patient after determining the likely source of the heel pain.

Most cases of plantar fasciitis can be treated without surgery. Depending on your condition, treatment may include:

• Supportive footwear – Properly supportive shoes can reduce stress on the heel and plantar fascia.
• Activity modification – Temporarily reducing activities that aggravate heel pain can give irritated tissue time to recover.
• Stretching exercises – Stretching the plantar fascia, calf muscles and Achilles tendon can improve flexibility and reduce tension on the heel.
• Ice and anti-inflammatory measures – These may be recommended to help decrease pain and inflammation.
• Custom orthotics – Prescription orthotics can improve foot mechanics and reduce excessive stress on the plantar fascia.
• Plantar fasciitis night splints – Night splints maintain the foot in a gently stretched position while sleeping and may help reduce first-step morning pain.
• Injections – When appropriate, certain injections may be considered as part of a treatment plan. Ultrasound guidance may be used for some procedures to improve accuracy.
• Extracorporeal Pulse Activation Technology (EPAT) – For persistent plantar fasciitis that has not responded adequately to initial treatment, EPAT may be considered. This noninvasive treatment uses pressure waves to stimulate a healing response in the affected tissue.

Surgery is generally reserved for persistent cases that have not responded adequately to appropriate nonsurgical treatment. If surgery is being considered, your podiatrist will discuss the procedure, alternatives and expected recovery with you.

How do you Prevent Plantar Fasciitis?

Not every case of plantar fasciitis can be prevented, but reducing excessive stress on the plantar fascia may help lower your risk of developing heel pain or having symptoms return.

• Wear supportive shoes – Choose shoes that provide good arch support, cushioning and stability. Avoid frequently walking barefoot or wearing poorly supportive shoes, particularly on hard surfaces.
• Increase activity gradually – Sudden increases in walking, running or other repetitive activities can place additional stress on the plantar fascia. Increase activity levels gradually when possible.
• Stretch your calves and feet – Regular stretching of the calf muscles, Achilles tendon and plantar fascia can help maintain flexibility and reduce tension on the heel.
• Maintain a healthy body weight – Excess body weight can increase the amount of stress placed on the feet and plantar fascia.
• Replace worn-out athletic shoes – Shoes lose cushioning and support over time. Replace footwear when it becomes excessively worn.
• Pay attention to recurring heel pain – If heel pain begins to return, modifying aggravating activities and having the problem evaluated early may help prevent symptoms from becoming more severe.

Even with appropriate footwear and preventive measures, plantar fasciitis can still occur. Persistent or recurring heel pain should be evaluated to determine its cause and appropriate treatment.

Heel Pain Treatment at Our Texas Locations

Family Foot & Ankle Centers provides evaluation and treatment for heel pain and plantar fasciitis at our three convenient locations in Waxahachie, Corsicana and Ennis, Texas. Each office provides care for patients experiencing plantar fasciitis and other causes of heel pain.

Learn more about heel pain care at each of our locations:

• Heel Pain Treatment in Waxahachie, TX
• Heel Pain Treatment in Corsicana, TX
• Heel Pain Treatment in Ennis, TX

Schedule an Appointment for Heel Pain

If heel pain is interfering with your daily activities, the podiatrists at Family Foot & Ankle Centers can evaluate your symptoms, determine the likely cause and recommend a treatment plan based on your individual condition.

Schedule an appointment at our Waxahachie, Corsicana or Ennis office at 972-597-4132 or by clicking here to use our convenient online appointment request form.

Family Foot & Ankle Centers has locations in Waxahachie, Corsicana and Ennis, TX.  We proudly serve patients in Navarro and Ellis counties and surrounding areas including Red Oak, Midlothian, Desoto, Cedar Hill, Lancaster, Duncanville, Arlington and Mansfield.