Heel Pain (Plantar Fasciitis) Treatments

Plantar Fasciitis is one of the most common causes of heel pain. The plantar fascia is a ligament that supports the arch of the foot. Plantar fasciitis occurs when this ligament gets over stressed, damaged and inflamed.

Cause: 

Some common causes of heel pain / plantar fasciitis include, but not limited to:

  • Weight gain
  • Excessive physical activity
  • Abnormal (gait) walking pattern
  • Improper or ill-fitting shoes
  • High impact activities (i.e. repetitive jumping, certain sports like tennis, basketball and certain exercise programs)
  • Tight calf muscles and achilles tendon

Presentation:

The heel can be painful, red, and/or swollen. The first steps out of bed or after a period of prolonged rest are very painful. Sometimes it is described as a sharp, knife-like pain in the heel with that first step in the morning. The pain improves but does not go away after those first few steps. At the end of the day, after prolonged standing or walking, the pain can get worse. This can occur in one foot or both feet.

 

Diagnosis:

  • X-Rays are taken to evaluate the heel bone for a spur and to rule out other pathology such as fractures.
  • Ultrasound can be used as needed to assess the thickness of the plantar fascia and assess for any plantar fascia tears.
  • Clinical examination will be done to assess the heel, foot, and also the achilles tendon which plays a significant role in the inflammation of the plantar fascia.
  • Gait exam to evaluate and address the underlying biomechanical problems.
 

Treatment:

  • Strapping
  • Stretching
  • Corticosteroid injection(s)
  • Oral anti-inflammatory medication
  • Shoe gear change/modifications
  • Custom Orthotics
  • Night Splints
  • Immobilization with a cast or a walking cast boot
  • Extracorporeal Shock Wave Therapy (ESWT / EPAT)
  • Physical Therapy
   

Plantar Fasciitis can become a chronic condition if not treated. It is important to seek care when the problem first appears and to address the underlying cause rather than waiting for it to become worse.

Heel Pain in Children

As children go through “growth spurts” between the age of 11 and 14, the muscles and tendons in their legs can become tight as they try to keep up with the rapid growth in the long bones. Heel pain in children typically is the result of a tight Achilles tendon.

In children, there is a thin irregular shaped band of cartilage in the back portion of the heel bone called a growth plate (see x-ray image below). As the name implies, new bone forms within a growth plate, which is also found in other bones in the feet, legs, hands and arms.

As a child goes through a "growth spurt," the rapidly elongating leg bones stretch the Achilles tendon which in turn pulls tighter on its insertion into the heel bone. A tight tendon is usually not a problem. However, when a child is very active in sports, such as soccer, or basketball, the increased activity creates further tightening of the tendon. The result is a traction or pulling force which is absorbed into the heel bone (see illustration, below).

As cartilage is softer than bone, the growth plate frequently becomes irritated and painful as the traction force increases. This process is more commonly seen between the age of 8 and 13 years old.

On examination, one can reproduce pain by pressing both under the heel as well as compressing the heel bone (calcaneus) from side to side. Other causes of heel pain include a fracture or bone tumor, so x-rays are usually performed in evaluating this condition.

Treatment includes rest, ice and anti-inflammatory medication. An arch support and heel lift are both helpful. For severe cases, a non-weight bearing splint or cast may be applied. Long term treatment usually includes use of functional foot orthotics. The problem is self-limiting and goes away after the growth plate closes, around the age of 13 to 14 years old.

FASMA Doctors Performing This Specialty / Service

Locations

  1. Silver Spring, MD (Fenton)
    8630 Fenton Street Suite 324
    Silver Spring, MD 20910
    Phone: 301-587-5666
    Fax: 301-589-4479

  2. Washington, DC (1775 K Street)
    1775 K Street NW Suite 580
    Washington, DC 20006
    Phone: 202-331-9727
    Fax: 202-887-0741

  3. Chapel Hill, NC
    1506 E. Franklin Street Suite 104
    Chapel Hill, NC 27514
    Phone: 919-960-8858
    Fax: 919-960-2882

  4. Charlottesville, VA (Abbey Road)
    2050 Abbey Road Suite C
    Charlottesville, VA 22911
    Phone: 434-295-4443
    Fax: 434-295-8598

  5. Culpeper, VA
    530 Sunset Lane Suite A
    Culpeper, VA 22701
    Phone: 540-825-6113
    Fax: 540-825-4937

  6. Frederick, MD (Thomas Johnson Drive)
    63 Thomas Johnson Dr Suite C
    Frederick, MD 21702
    Phone: 301-696-0818
    Fax: 301-696-8872

  7. Washington, DC (19th Street)
    1145 19th Street NW Suite 605
    Washington, DC 20036
    Phone: 202-833-9109
    Fax: 202-833-5762

  8. Palmetto Podiatry Group of Anderson
    2126B N Hwy 81
    Anderson, SC 29621
    Phone: (864) 231-6395
    Fax: (864) 231-6520

  9. Manassas, VA
    8577A Sudley Rd
    Manassas, VA 20110
    Phone: (703) 368-7166
    Fax: (703) 368-5103

  10. Reston, VA (Reston Pkwy)
    1760 Reston Pkwy., Ste 310
    Reston, VA 20190
    Phone: (703) 723-2719
    Fax: (866) 453-6775

  11. Mt Airy, MD (South)
    1502 S. Main Street Suite 307
    Mt Airy, MD 21771
    Phone: 301-829-2244
    Fax: 833-915-0243

  12. Raleigh, NC (Wake Forest Rd)
    3801 Wake Forest Rd Suite 100
    Raleigh, NC 27609
    Phone: 919-850-9111
    Fax: 919-850-2499

  13. Charlotte, NC (South Park)
    6831 Fairview Road A
    Charlotte, NC 28210
    Phone: 704-376-3947
    Fax: 704-376-9487

  14. Holly Springs, NC
    1004 Werrington Drive, Ste. 300
    Holly Springs, NC 27540
    Phone: 919-850-9111
    Fax: 919-850-2499

  15. Charlottesville, VA (Rio East Ct)
    887 Rio East Ct. Suite A
    Charlottesville, VA 22901
    Phone: 434-979-8116
    Fax: 434-979-8880

  16. Fishersville, VA
    66 Parkway Lane Suite 102
    Fishersville, VA 22939
    Phone: 540-949-5150
    Fax: 540-932-8535

  17. Ashburn, VA
    20905 Professional Plaza, Ste 310
    Ashburn, VA 20147
    Phone: (703) 723-9267
    Fax: (866) 453-6775

  18. McLean, VA
    1313 Dolley Madison Blvd., Suite 403
    McLean, VA 22101
    Phone: (703) 556-8637
    Fax: (866) 453-6775

  19. Reston, VA (Hospital Campus)
    1860 Town Center Drive Suite 220
    Reston, VA 20190
    Phone: 703-391-0211
    Fax: 703-880-1192

  20. Gastonia
    251 Wilmot Dr
    Gastonia, NC 28054
    Phone: 704-861-0425
    Fax: 704-861-0274

  21. Alpine Podiatry – Rock Hill
    430 S. Herlong Avenue, Suite 105
    Rock Hill, SC 29732
    Phone: (803) 327-2217
    Fax: (803) 327-2272

  22. Cary, NC
    103 Parkway Office Court Suite 100
    Cary, NC 27518
    Phone: 919-481-3338
    Fax: 919-467-2436

  23. Dunn, NC
    700 Tilghman Drive Suite 722
    Dunn, NC 28334
    Phone: 910-892-3338
    Fax: 910-892-2706

  24. Lake Ridge, VA
    1721 Financial Loop
    Lake Ridge, VA 22192
    Phone: (703) 491-9500
    Fax: (703) 491-9994

  25. Stafford, VA
    945 Garrisonville Road
    Stafford, VA 22554
    Phone: (540) 720-0700
    Fax: (540) 720-4449

  26. Henderson, NC
    451 Ruin Creek Road Suite 202
    Henderson, NC 27536
    Phone: 252-438-4426
    Fax: 252-430-1709

  27. Rockville, MD (North Bethesda)
    11801 Rockville Pike Suite 105
    Rockville, MD 20852
    Phone: 301-881-6222
    Fax: 301-881-1639

  28. Kensington, MD
    10901 Connecticut Avenue Suite 200
    Kensington, MD 20895
    Phone: 301-949-2000
    Fax: 301-949-2002

  29. Rockville, MD (Shady Grove Rd)
    15215 Shady Grove Rd Suite 307
    Rockville, MD 20850
    Phone: 240-268-7450
    Fax: 301-949-8833

  30. Chevy Chase, MD
    5530 Wisconsin Avenue Suite 945
    Chevy Chase, MD 20815
    Phone: 301-913-5225
    Fax: 301-913-9145

  31. Silver Spring, MD (International Drive)
    3801 International Drive Suite 204
    Silver Spring, MD 20906
    Phone: 301-598-0130
    Fax: 301-598-5091

  32. Clarksville, MD
    6100 Day Long Lane Suite 208
    Clarksville, MD 21029
    Phone: 443-535-8770
    Fax: 443-535-8775

  33. Apex, NC
    1001 Pemberton Hill Road Suite 102
    Apex, NC 27502
    Phone: 919-363-3310
    Fax: 919-363-3370

  34. Concord, NC
    492 Copperfield Blvd NE
    Concord, NC 28025
    Phone: 704-788-9797
    Fax: 704-788-6830

  35. University, NC
    8310 Medical Plaza Drive Suite E
    Charlotte, NC 28262
    Phone: 704-548-0222
    Fax: 704-548-1157

  36. Ballantyne, NC
    9216 Ardrey Kell Road Suite 100
    Charlotte, NC 28277
    Phone: 704-544-6517
    Fax: 704-544-2988

  37. Frederick, MD (Solarex Ct)
    604 Solarex Court Suite 103
    Frederick, MD 21703
    Phone: 301-698-9260
    Fax: 301-698-8962

  38. Greencastle, PA
    50 Eastern Ave Suite 122
    Greencastle, PA 17225
    Phone: 717-643-0795
    Fax: 717-643-0833

  39. Hagerstown, MD
    11110 Medical Campus Road Suite 100
    Hagerstown, MD 21742
    Phone: 301-739-1575
    Fax: 301-739-1578

  40. Gettysburg, PA
    506 W. Middle Street
    Gettysburg, PA 17325
    Phone: 717-778-3338
    Fax: 717-778-3340

  41. Wake Foot & Ankle – Wake Forest
    833C Wake Forest Business Park
    Wake Forest, NC 27587
    Phone: 919-230-7233

  42. Alleghany, VA
    1 ARH Lane Suite 101
    Low Moor, VA 24457
    Phone: 540-344-3668
    Fax: 540-774-4615

  43. Roanoke, VA
    222 Walnut Avenue SW
    Roanoke , VA 24016
    Phone: 540-344-3668
    Fax: 540-343-2457

  44. Salem, VA
    1802 Braeburn Drive Suite A2130
    Salem, VA 24153
    Phone: 540-344-3668
    Fax: 540-774-4615



  45. ,
    Phone:

  46. Charlotte, NC (Pineville)
    10370 Park Rd. #100
    Charlotte, NC 28210
    Phone: 704-542-8253

  47. Private: Benson, NC
    1 Medical Drive
    Benson, NC 27504
    Phone: 919-363-3310
    Fax: 919-363-3370

  48. Matthews, NC
    534 West John St. Suite 100
    Matthews, NC 28105
    Phone: 704-847-9788

  49. Waxhaw, NC
    323 N. Broome St.
    Waxhaw, NC 28173
    Phone: 704-847-9788

  50. Lincolnton, NC
    626 Clark Dr.
    Lincolnton, NC 28092
    Phone: 704-847-9788

  51. Pasadena, MD
    8155 Ritchie Highway Suite B
    Pasadena, MD 21122
    Phone: 410-768-5800
    Fax: 410-768-5806

  52. Harrisburg, NC
    3800 Highway 49 South
    Harrisburg, NC 28075
    Phone: 704-455-2999
    Fax: 704-455-1624

  53. Columbia, MD
    11055 Little Patuxent Pkwy Suite 204
    Columbia, MD 21044
    Phone: 410-730-2623
    Fax: 410-992-4779

  54. Fairfax, VA (Hamaker Court)
    3020 Hamaker Court Suite 201
    Fairfax, VA 22031
    Phone: 703-207-0073

  55. Annapolis, MD
    129 Lubrano Drive Suite 303
    Annapolis, MD 21401
    Phone: 410-266-7575
    Fax: 410-266-7366

  56. Colonial Heights, VA
    4720 Puddledock Road Suite 120
    Prince George, VA 23875
    Phone: 804-320-3668
    Fax: 844-468-5770

  57. Richmond, VA
    1465 Johnston Willis Drive
    Richmond, VA 23235
    Phone: 804-320-3668
    Fax: 844-468-5770

  58. Silver Spring, MD (White Oak)
    2415 Musgrove Road Suite 103
    Silver Spring, MD 20904
    Phone: 301-384-6500
    Fax: 301-384-6670

  59. Alpine Podiatry – Fort Mill
    105 Ben Casey Drive, Suite 133
    Fort Mill, SC 29708
    Phone: (803) 396-8670
    Fax: (803) 396-8657

  60. Huntersville, NC
    16419 Northcross Dr Suite A
    Huntersville, NC 28078
    Phone: 704-987-9585

  61. Harrisburg, PA
    4033 Linglestown Road Suite 1
    Harrisburg, PA 17112
    Phone: 717-651-0000

  62. Hampton, VA
    2210 Executive Drive Suite E
    Hampton, VA 23666
    Phone: 757-896-8800
    Fax: 757-896-8832

  63. Newport News, VA
    754 McGuire Place
    Newport News, VA 23601
    Phone: 757-599-5710
    Fax: 757-591-0552

  64. Greenbelt, MD
    7501 Greenway Center Dr Suite 810
    Greenbelt, MD 20770
    Phone: 301-577-4464
    Fax: 301-577-4702

  65. Mountain Island, NC
    10310 Couloak Drive Suite 200
    Charlotte, NC 28216
    Phone: 704-971-4000
    Fax: 704-971-2379

  66. Mechanicsburg, PA
    2025 Technology Parkway Suite 201
    Mechanicsburg, PA 17050
    Phone: 717-651-0000

  67. Gaithersburg, MD
    702 Russell Avenue, Suite 103 PNC Bank Building
    Gaithersburg, MD 20877
    Phone: (301) 948-3668
    Fax: (301) 926-7787

  68. Newport, PA
    300 Bretz Ct
    Newport, PA 17074
    Phone: 717-651-0000

  69. Martinsville, VA
    1 Dudley Street
    Martinsville, VA 24112
    Phone: 540-344-3668
    Fax: 540-774-4615

  70. Mooresville, NC
    206 Joe Knox Avenue Suite D
    Mooresville, NC 28117
    Phone: 704-235-0474
    Fax: 704-660-3987