The most common cause of arch and heel pain is a condition called plantar fasciitis. This is an inflammation of a thick band of tissue that runs along the arch of your feet from your heel to your toes, and aids in the stabilization of your arch during walking and running. Symptoms involve two areas—the arch, and more commonly, the inside heel area. Severe pain can be present, especially in the morning on arising. Common symptoms of plantar fasciitis include:
- Pain in the morning when you first get out of bed
- Pain and stiffness when you start to walk after sitting for a while
- Increasing arch or heel pain toward the end of the day
- Tired feet at the end of the day
Other causes of arch and heel pain include arthritis, infection, fractures and sprains, and even certain systemic diseases. Since there are multiple possible causes, you should see your podiatrist for a thorough evaluation if you are experiencing arch or heel pain that does not respond quickly to early treatment.
What causes Plantar Fasciitis?
Arch and heel pain is usually the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. This increased stress causes local inflammation and pain. The most common cause of the stress is a condition where the inside arch of the foot flattens more than it should (often known as "over-pronation"). When the arch of the foot flattens, it also gets longer, causing a stretch on the plantar fascia. In response, the heel becomes inflamed where the plantar fascia attaches.
How is Plantar Fasciitis treated?
The SHOES-n-FEET® Medical Advisory Committee tells us that plantar fasciitis almost always responds to conservative treatment. Early treatment should focus on reducing the “tugging" on the plantar fascia.
- Wear stable shoes.
- Use high-quality over-the-counter arch supports in your shoes.
- Ice your feet several times per day.
What if the pain doesn't go away?
In more difficult cases of plantar fasciitis you should see your foot health professional for a thorough examination. They will find out why your arch or heel pain occurred in the first place and devise a treatment plan to relieve your pain and prevent it from reoccurring. They will evaluate your feet, walking pattern (gait), shoes, activities, exercise methods, and other relevant information and then devise your treatment plan.
Is Surgery Ever Necessary?
The SHOES-n-FEET Medical Advisory Committee informs us that with adequate conservative care, surgery is almost never necessary for plantar fasciitis.
You should always give conservative treatment at least six months to work. Conservative treatment may include several of the following: physical therapy, anti-inflammatory medications, exercises, shoe recommendations, prefabricated arch supports and/or custom prescription orthotics.