- Simple Steps to Soothe Heel Pain
- Heel Pain
- What Is It?
- Natural Remedies For Heel Pain
- Physical Practices to Relieve Heel Pain
- Natural Remedies for Heel Pain
- Physical Support for Your Feet
- Still Not Convinced?
- Articles Recommended for You:
- Are there any other treatments?
- What about surgery?
- What is the outlook (prognosis)?
- Can it be prevented?
Simple Steps to Soothe Heel Pain
Plantar Fasciitis Treatment: Other Treatments
If those suggestions don’t help ease heel pain, your doctor may recommend the following treatments:
- Wearing a special splint at night. This helps by maintaining a slight stretch of the plantar fascia while sleeping.
- Physical therapy
- Custom shoes or inserts (orthotics)
For more serious heel pain, more aggressive measures can be taken:
- A shot of cortisone to reduce the inflammation. This can be effective, but tends to be painful.
- Extracorporeal shock wave therapy, in which external shock waves are directed to the inflamed areas of plantar fascia. Success with this procedure has been mixed, and it tends to work best with plantar fasciitis patients who are also runners.
- Various surgical procedures. This is usually a last-resort treatment, and only if pain is still there after many months of other treatments.
Plantar Fasciitis: Prevention
There are many triggers for plantar fasciitis, so it’s important to learn how to reduce your risk. Being obese puts extra pressure on your feet, so losing weight is a good idea if you struggle with heel pain.
The shoes you wear can also make a big difference in how your feet feel, so protect your feet and heels with shoes that offer good support in the arch and a wide, stable heel. Don’t wear worn-out shoes; replace them when there is noticeable wear on the sole. Also, don’t walk barefoot on hard surfaces.
Exercise will also affect plantar fascitis. Always warm up, and never rush into a new activity — take your time, and let your muscles get used to the exercise. And invest in a pair of cushioned running shoes, which should be replaced regularly.
Heel pain is certainly a bother, but don’t let it stop you in your tracks. Recognize the symptoms of plantar fasciitis, and give your feet the break they deserve.
What Is It?
Published: February, 2019
Heel pain is a common symptom that has many possible causes. Although heel pain sometimes is caused by a systemic (body-wide) illness, such as rheumatoid arthritis or gout, it usually is a local condition that affects only the foot. The most common local causes of heel pain include:
- Plantar fasciitis — Plantar fasciitis is a painful inflammation of the plantar fascia, a fibrous band of tissue on the sole of the foot that helps to support the arch. Plantar fasciitis occurs when the plantar fascia is overloaded or overstretched. This causes small tears in the fibers of the fascia, especially where the fascia meets the heel bone. Plantar fasciitis may develop in just about anyone but it is particularly common in the following groups of people: people with diabetes, obese people, pregnant women, runners, volleyball players, tennis players and people who participate in step aerobics or stair climbing. You also can trigger plantar fasciitis by pushing a large appliance or piece of furniture or by wearing worn out or poorly constructed shoes. In athletes, plantar fasciitis may follow a period of intense training, especially in runners who push themselves to run longer distances. People with flat feet have a higher risk of developing plantar fasciitis.
- Heel spur — A heel spur is an abnormal growth of bone at the area where the plantar fascia attaches to the heel bone. It is caused by long-term strain on the plantar fascia and muscles of the foot, especially in obese people, runners or joggers. As in plantar fasciitis, shoes that are worn out, poorly fitting or poorly constructed can aggravate the problem. Heel spurs may not be the cause of heel pain even when seen on an X-ray. In fact, they may develop as a reaction to plantar fasciitis and they can also be found in people without pain or problems in the heel.
- Calcaneal apophysitis — In this condition, the center of the heel bone becomes irritated as a result of a new shoe or increased athletic activity. This pain occurs in the back of the heel, not the bottom. Calcaneal apophysitis is a fairly common cause of heel pain in active, growing children between the ages of 8 and 14. Although almost any boy or girl can be affected, children who participate in sports that require a lot of jumping have the highest risk of developing this condition.
- Bursitis — Bursitis means inflammation of a bursa, a sac that lines many joints and allows tendons and muscles to move easily when the joint is moving. In the heel, bursitis may cause pain at the underside or back of the heel. In some cases, heel bursitis is related to structural problems of the foot that cause an abnormal gait (way of walking). In other cases, wearing shoes with poorly cushioned heels can trigger bursitis.
- Pump bump — This condition, medically known as posterior calcaneal exostosis, is an abnormal bony growth at the back of the heel. It is especially common in young women, in whom it is often related to long-term bursitis caused by pressure from pump shoes.
- Local bruises — Like other parts of the foot, the heel can be bumped and bruised accidentally. Typically, this happens as a “stone bruise,” an impact injury caused by stepping on a sharp object while walking barefoot.
- Achilles tendonitis — In most cases, Achilles tendonitis (inflammation of the Achilles tendon) is triggered by overuse, especially by excessive jumping during sports. However, it also can be related to poorly fitting shoes if the upper back portion of a shoe digs into the Achilles tendon at the back of the heel. Less often, it is caused by an inflammatory illness, such as ankylosing spondylitis (also called axial spondylarthritis), reactive arthritis, gout or rheumatoid arthritis.
- Trapped nerve — Compression of a small nerve (a branch of the lateral plantar nerve) can cause pain, numbness or tingling in the heel area. In many cases, this nerve compression is related to a sprain, fracture or varicose (swollen) vein near the heel.
The heel can be painful in many different ways, depending on the cause:
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Natural Remedies For Heel Pain
Physical Practices to Relieve Heel Pain
Rest – Yes, this seems like it should be a no-brainer, but you may be one of those busy people who makes time for everything and everyone but themselves. If your feet have become unhealthy due to overuse, obesity, high-impact sports or ill-fitting shoes, they are begging you to prop them up and let them rest. At the very least, kick back with your feet elevated for twenty minutes, twice a day. Yes, you can watch TV while you do this (or better yet, read a great book about holistic medicine!). The main thing is to be totally relaxed and give your feet a break from all of the support they are giving you every day, with each step you take.
Ice – While you’re resting your tired dogs, put an ice pack on your heels. Don’t have an ice pack? Wrap ice cubes up in a towel. There is no less expensive way to quickly lessen inflammation and numb soreness. While ice will not cure underlying conditions like Plantar Fasciitis, plantar fascia tears or heel spurs, it can make life a little more bearable each day until your other healing efforts have time to go into effect.
Stretch – In the condition of Planar Fasciitis, the biomechanics of the foot become unbalanced as the plantar fascia ligament spanning your foot from heel to ball stretches beyond a normal range of motion and develops inflammation and small tears. Doing the right foot stretches can help to strengthen this vital ligament and prevent further injury. Check out these free instructional heel stretching videos.
Shop – No, this isn’t your chance to place the blame for a spending spree on that nagging heel pain, but it is a plea to make your next footwear purchase a really sensible one. Podiatrists cite poorly fitting shoes as a leading cause of poor foot health. High heels or any type of shoe not offering a roomy fit, good support and a natural elevation can lead to ingrown toenails, bunions, irreversible damage to the feet and legs, chronic hip and back problems, dangerous falls and – you guessed it – Plantar Fasciitis. Shoes that have worn insoles can also cause serious problems and pain. Prove that you appreciate your feet by making your next shoe purchase all about their comfort and not about some marketer’s goofy idea of high fashion!
Natural Remedies for Heel Pain
Vitamins & Minerals – Did you know that there are vitamins and minerals that have been clinically proven to play a part in the health of the components of your feet? Check out this great, free list of vitamins and minerals for heel pain. In some cases, you can access these helpful substances from the foods you eat. In more severe cases, you may wish to take some in supplement form to ensure you’re getting high enough doses to combat a tough health problem.
Soaks & Packs – Try epsom salts or arnica salts in the bath for a foot soak, or soak a washcloth in heated linseed oil and apply it to your heel. These are tried-and-true folk remedies for all kinds of aches and pains.
Teas – Dealing with ongoing pain can grate on your nerves and leave your whole body feeling tight and wound up. Try chamomile tea to sooth your nerves and promote sound sleep. Tea containing the herb valerian acts as a natural muscle relaxant. Teas containing the flowers of the hops plant are believed to calm anxiety and tone down feelings of irritability. To combat inflammation, look for teas containing the root turmeric or its pigment curcumin. Boswellia is another plant believed to contain powerful anti-inflammatory agents. Plantar Fasciitis sufferers often confess that they know they’ve become snappish with their loved ones because coping with the pain in their heels has put a real strain on their nerves. Herbal teas can help you relax and regain a feeling of well-being, enabling you to interact in a sunnier fashion with friends and family again.
*Always check with a doctor before starting to take a new herbal, vitamin or mineral supplement in any form.
Physical Support for Your Feet
Fascia-Bar Treatments – Podiatrists state that more than 90% of cases of Plantar Fasciitis and heel pain can be treated without drugs or surgery. Rest, icing, stretching and supplements can all relieve pain and speed healing, but on-site treatment of the physical problem will be vital to your recovery. Fascia-Bar technology was developed by Chief Pedorthist, Art Smucker, through an intensive thirty year period of research and development, the goal of which was to design an orthotic support specifically for Plantar Fasciitis sufferers. This clinically-proven, patented technology is found in the lineup of orthotic inserts, wraps and splints, and not in any other product on the market. With daily wear of a product like Heel Seats, you will be promoting healing via the following features:
- Realignment of your foot’s biomechanics
- Gentle lifting, stretching and strengthening of the plantar fascia ligament
- Cushioning sore, worn down heels with dense, supportive padding
- The application of acupressure to the heel bone, stimulating a healing response from your body
Most Plantar Fasciitis sufferers report significant heel pain reduction within about a week, and all products we feature come with a money-back guarantee. Best of all, this is an affordable home remedy – something you can do each day, on your own, to heal your condition. No doctors, no physical therapists, no dangerous drugs or costly surgeries. And better than a 9 out of 10 chance that use of Fascia-Bar technology coupled with simple practices like resting, icing and stretching could rid you of that heel pain for good!
Still Not Convinced?
We have a very simple priority here at Heel That Pain that governs everything we do: we want to get you out of pain and help you recover as quickly and safely as possible. Getting you health back is so important to us that we’ve invested oodles of time and funding in creating this website, chock-full of free educational materials and videos for the home treatment of heel pain via natural, non-invasive methods.
But maybe just reading about it just isn’t your thing.
Would you like the chance to speak directly with a heel pain support technician? Maybe you have some tough questions that you want answers to, or maybe you’d just like to chat with someone who understands what you’ve been going through trying to cope with daily pain.
Accept this as your invitation to call our patient helpline at 877-215-3200. We’re here to help you!
Articles Recommended for You:
Heel Pain Treatment
Causes of Heel Pain
When Plantar Fasciitis Won’t Go Away
More than 90% of patients with plantar fasciitis will improve within 10 months of starting simple treatment methods.
Rest. Decreasing or even stopping the activities that make the pain worse is the first step in reducing the pain. You may need to stop athletic activities where your feet pound on hard surfaces (for example, running or step aerobics).
Ice. Rolling your foot over a cold water bottle or ice for 20 minutes is effective. This can be done 3 to 4 times a day.
Nonsteroidal anti-inflammatory medication. Drugs such as ibuprofen or naproxen reduce pain and inflammation. Using the medication for more than 1 month should be reviewed with your primary care doctor.
Exercise. Plantar fasciitis is aggravated by tight muscles in your feet and calves. Stretching your calves and plantar fascia is the most effective way to relieve the pain that comes with this condition.
- Calf stretch
Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.
- Plantar fascia stretch
This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you in a controlled fashion. If it is difficult to reach your foot, wrap a towel around your big toe to help pull your toes toward you. Place your other hand along the plantar fascia. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot. This exercise is best done in the morning before standing or walking.
Cortisone injections. Cortisone, a type of steroid, is a powerful anti-inflammatory medication. It can be injected into the plantar fascia to reduce inflammation and pain. Your doctor may limit your injections. Multiple steroid injections can cause the plantar fascia to rupture (tear), which can lead to a flat foot and chronic pain.
Supportive shoes and orthotics. Shoes with thick soles and extra cushioning can reduce pain with standing and walking. As you step and your heel strikes the ground, a significant amount of tension is placed on the fascia, which causes microtrauma (tiny tears in the tissue). A cushioned shoe or insert reduces this tension and the microtrauma that occurs with every step. Soft silicone heel pads are inexpensive and work by elevating and cushioning your heel. Pre-made or custom orthotics (shoe inserts) are also helpful.
Soft heel pads can provide extra support.
Night splints. Most people sleep with their feet pointed down. This relaxes the plantar fascia and is one of the reasons for morning heel pain. A night splint stretches the plantar fascia while you sleep. Although it can be difficult to sleep with, a night splint is very effective and does not have to be used once the pain is gone.
Physical therapy. Your doctor may suggest that you work with a physical therapist on an exercise program that focuses on stretching your calf muscles and plantar fascia. In addition to exercises like the ones mentioned above, a physical therapy program may involve specialized ice treatments, massage, and medication to decrease inflammation around the plantar fascia.
Extracorporeal shockwave therapy (ESWT). During this procedure, high-energy shockwave impulses stimulate the healing process in damaged plantar fascia tissue. ESWT has not shown consistent results and, therefore, is not commonly performed.
ESWT is noninvasive—it does not require a surgical incision. Because of the minimal risk involved, ESWT is sometimes tried before surgery is considered.
Painkillers such as paracetamol will often ease the pain. Sometimes anti-inflammatory medicines such as ibuprofen are useful. These are painkillers but also reduce inflammation and may work better than ordinary painkillers. Some people find that rubbing a cream or gel that contains an anti-inflammatory medicine on to their heel is helpful.
An ice pack (such as a bag of frozen peas wrapped in a tea towel) held to your foot for 15-20 minutes may also help to relieve pain.
Regular, gentle stretching of your Achilles tendon and plantar fascia may help to ease your symptoms. This is because most people with plantar fasciitis have a slight tightness of their Achilles tendon. If this is the case, it tends to pull at the back of your heel and has a knock-on effect of keeping your plantar fascia tight. Also, when you are asleep overnight, your plantar fascia tends to tighten up (which is why it is usually most painful first thing in the morning). The aim of these exercises is to loosen up the tendons and fascia gently above and below your heel. Your doctor may refer you to a physiotherapist for exercise guidance.
Watch our physiotherapist taking you through all the exercises for plantar fasciitis in our video.
Exercises (done with or without shoes on) to help treat plantar fasciitis
Choosing the correct footwear can help to reduce pain
- Stand about 40 cm away from a wall and put both hands on the wall at shoulder height, feet slightly apart, with one foot in front of the other. Bend your front knee but keep your back knee straight and lean in towards the wall to stretch. You should feel your calf muscle tighten. Keep this position for several seconds, then relax. Do this about 10 times then switch to the other leg. Now repeat the same exercise for both legs but this time, bring your back foot forward slightly so that your back knee is also slightly bent. Lean against the wall as before, keep the position, relax and then repeat 10 times before switching to the other leg. Repeat this routine twice a day.
- Stand on the bottom step of some stairs with your legs slightly apart and with your heels just off the end of the step. Hold the stair rails for support. Lower your heels, keeping your knees straight. Again you should feel the stretch in your calves. Keep the position for 20-60 seconds, then relax. Repeat six times. Try to do this exercise twice a day.
- Sit on the floor with your legs out in front of you. Loop a towel around the ball of one of your feet. With your knee straight, pull your toes towards your nose. Hold the position for 30 seconds and repeat three times. Repeat the same exercise for the other foot. Try to do this once a day.
- Sit on a chair with your knees bent at right angles and your feet and heels flat on the floor. Lift your foot upwards, keeping your heel on the floor. Hold the position for a few seconds and then relax. Repeat about 10 times. Try to do this exercise five to six times a day.
- For this exercise you need an object such as a rolling pin or a drinks can. Whilst sitting in a chair, put the object under the arch of your foot. Roll the arch of your foot over the object in different directions. Perform this exercise for a few minutes for each foot at least twice a day. This exercise is best done without shoes on.
Plantar Fasciitis Management Options
Each treatment option for Plantar Fasciitis has various benefits, risks and consequences. In collaboration with health.org.uk, we’ve put together a summary decision aid that encourages patients and doctors to discuss and assess what’s available.
Are there any other treatments?
If the above treatments are not helping to relieve your symptoms, or if you are someone such as an athlete who needs a quick recovery, other treatments are available. There is no one specific treatment that appears to stand out as the best.
A steroid (cortisone) injection is sometimes tried if your pain remains bad despite the above ‘conservative’ measures. It may relieve the pain in some people for several weeks but does not always cure the problem. It is not always successful and may be sore to have done. Steroids work by reducing inflammation. Sometimes two or three injections are tried over a period of weeks if the first is not successful. Steroid injections do carry some risks, including (rarely) tearing (rupture) of the plantar fascia.
Extracorporeal shock-wave therapy
In extracorporeal shock-wave therapy, a machine is used to deliver high-energy sound waves through your skin to the painful area on your foot. It is not known exactly how it works but it is thought that it might stimulate healing of your plantar fascia. One or more sessions of treatment may be needed.
This procedure appears to be safe but it is uncertain how well it works. This is mostly because of a lack of large, well-designed clinical trials. You should have a full discussion with your doctor about the potential benefits and risks.
In studies, most people who have had extracorporeal shock-wave therapy have little in the way of problems. However, possible problems that can occur include pain during treatment, skin reddening, and swelling of your foot or bruising. Another theoretical problem could include the condition becoming worse because of rupture of your plantar fascia or damage to the tissues in your foot. More research into extracorporeal shock-wave therapy for plantar fasciitis is needed.
Other possible treatments
Various studies and trials have been carried out looking at other possible treatments for plantar fasciitis. Such treatments include injection with botulinum toxin and treatment of the plantar fascia with radiotherapy. These treatments may not be widely available.
Some people benefit from wearing a special splint overnight to keep their Achilles tendon and plantar fascia slightly stretched. The aim is to prevent the plantar fascia from tightening up overnight. In very difficult cases, sometimes a plaster cast or a removable walking brace is put on the lower leg. This provides rest, protection, cushioning and slight stretching of the plantar fascia and Achilles tendon. However, the evidence for the use of splint treatment of plantar fasciitis is limited.
What about surgery?
This may be considered in very difficult cases. Surgery is usually only advised if your pain has not eased after 12 months despite other treatments. The operation involves separating your plantar fascia from where it connects to the bone; this is called a plantar fascia release. It may also involve removal of a spur on the heel bone (calcaneum) if one is present. Surgery is not always successful. It can cause complications in some people so it should be considered as a last resort. Complications may include infection, increased pain, injury to nearby nerves, or rupture of the plantar fascia.
What is the outlook (prognosis)?
Most people have completely recovered from an episode of plantar fasciitis within a year. However, some of the treatments described above may help to speed up your recovery.
Can it be prevented?
There are certain things that you can do to try to prevent plantar fasciitis, especially if you have had it before. These include:
- Regularly changing training shoes used for running or walking.
- Wearing shoes with good cushioning in the heels and good arch support.
- Losing weight if you are overweight.
- Regularly stretching the plantar fascia and Achilles tendon, especially before exercise.
- Avoiding exercising on hard surfaces.