Plantar fasciitis (heel pain)
Plantar fasciitis is heel or arch pain from the plantar fascia, the band of tissue that runs from the heel bone to the toes. It is usually worst on the first steps in the morning or after rest. Footwear changes, stretching, strapping and orthotics can all help, and Fiona assesses it in an initial consultation from $100.
Symptoms
Plantar fasciitis causes pain under the heel or along the arch. The pain is usually worst on your first steps in the morning, and it often returns after rest, such as when you stand up from a chair. It follows the line of the plantar fascia from the heel towards the toes.
What causes it
Risk factors include feet that roll in (over-pronation), flat feet or high arches, long hours standing or walking on hard surfaces, tight calf muscles and a tight Achilles tendon, weight gain, and unsupportive footwear such as thongs or high heels (healthdirect). It is more common between the ages of 30 and 60.
When heel pain is something else
Heel pain is not always plantar fasciitis. Nerve irritation, bursitis, a stress fracture of the heel bone, an irritated fat pad and tendon overuse can all hurt in the same place. Fiona can refer you for an X-ray, ultrasound or MRI when it is needed.
Treatment at the clinic
Treatment can include footwear advice, calf and plantar fascia stretching, strapping, orthotics and changes to activity. Orthotics are used where your foot structure contributes: custom orthotics are from $650 and semi-custom from $450, both including a biomechanical assessment and fitting. Changes to sport or time on your feet can also be part of the plan.
What you can do now
Wear supportive shoes and avoid thongs. Stretch your calves, because tight calves and a tight Achilles tendon add to heel pain. healthdirect also lists stretches and supportive shoes among the treatments for plantar fasciitis.
Questions
How is plantar fasciitis treated?
Treatment can include supportive footwear, stretching, strapping, orthotics and changes to activity. healthdirect notes it can often last weeks or months.
Do orthotics help plantar fasciitis?
Orthotics are used where foot structure contributes. Fiona prescribes them after a biomechanical assessment. Wear them in over the first 2 to 3 weeks, and book a review when they cause pain or blisters.
Should I see a podiatrist or a GP for heel pain?
You can see a podiatrist privately without a referral. A GP referral is needed for a Medicare chronic condition management plan.