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
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Silver Spring, MD (Fenton)
8630 Fenton Street Suite 324
Silver Spring, MD 20910
Phone: 301-587-5666
Fax: 301-589-4479
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Washington, DC (1775 K Street)
1775 K Street NW Suite 580
Washington, DC 20006
Phone: 202-331-9727
Fax: 202-887-0741
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Chapel Hill, NC
1506 E. Franklin Street Suite 104
Chapel Hill, NC 27514
Phone: 919-960-8858
Fax: 919-960-2882
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Charlottesville, VA (Abbey Road)
2050 Abbey Road Suite C
Charlottesville, VA 22911
Phone: 434-295-4443
Fax: 434-295-8598
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Culpeper, VA
530 Sunset Lane Suite A
Culpeper, VA 22701
Phone: 540-825-6113
Fax: 540-825-4937
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Frederick, MD (Thomas Johnson Drive)
63 Thomas Johnson Dr Suite C
Frederick, MD 21702
Phone: 301-696-0818
Fax: 301-696-8872
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Washington, DC (19th Street)
1145 19th Street NW Suite 605
Washington, DC 20036
Phone: 202-833-9109
Fax: 202-833-5762
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Palmetto Podiatry Group of Anderson
2126B N Hwy 81
Anderson, SC 29621
Phone: (864) 231-6395
Fax: (864) 231-6520
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Manassas, VA
8577A Sudley Rd
Manassas, VA 20110
Phone: (703) 368-7166
Fax: (703) 368-5103
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Reston, VA (Reston Pkwy)
1760 Reston Pkwy., Ste 310
Reston, VA 20190
Phone: (703) 723-2719
Fax: (866) 453-6775
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Mt Airy, MD (South)
1502 S. Main Street Suite 307
Mt Airy, MD 21771
Phone: 301-829-2244
Fax: 833-915-0243
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Raleigh, NC (Wake Forest Rd)
3801 Wake Forest Rd Suite 100
Raleigh, NC 27609
Phone: 919-850-9111
Fax: 919-850-2499
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Charlotte, NC (South Park)
6831 Fairview Road A
Charlotte, NC 28210
Phone: 704-376-3947
Fax: 704-376-9487
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Holly Springs, NC
1004 Werrington Drive, Ste. 300
Holly Springs, NC 27540
Phone: 919-850-9111
Fax: 919-850-2499
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Charlottesville, VA (Rio East Ct)
887 Rio East Ct. Suite A
Charlottesville, VA 22901
Phone: 434-979-8116
Fax: 434-979-8880
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Fishersville, VA
66 Parkway Lane Suite 102
Fishersville, VA 22939
Phone: 540-949-5150
Fax: 540-932-8535
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Ashburn, VA
20905 Professional Plaza, Ste 310
Ashburn, VA 20147
Phone: (703) 723-9267
Fax: (866) 453-6775
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McLean, VA
1313 Dolley Madison Blvd., Suite 403
McLean, VA 22101
Phone: (703) 556-8637
Fax: (866) 453-6775
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Reston, VA (Hospital Campus)
1860 Town Center Drive Suite 220
Reston, VA 20190
Phone: 703-391-0211
Fax: 703-880-1192
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Gastonia
251 Wilmot Dr
Gastonia, NC 28054
Phone: 704-861-0425
Fax: 704-861-0274
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Alpine Podiatry – Rock Hill
430 S. Herlong Avenue, Suite 105
Rock Hill, SC 29732
Phone: (803) 327-2217
Fax: (803) 327-2272
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Cary, NC
103 Parkway Office Court Suite 100
Cary, NC 27518
Phone: 919-481-3338
Fax: 919-467-2436
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Dunn, NC
700 Tilghman Drive Suite 722
Dunn, NC 28334
Phone: 910-892-3338
Fax: 910-892-2706
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Lake Ridge, VA
1721 Financial Loop
Lake Ridge, VA 22192
Phone: (703) 491-9500
Fax: (703) 491-9994
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Stafford, VA
945 Garrisonville Road
Stafford, VA 22554
Phone: (540) 720-0700
Fax: (540) 720-4449
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Henderson, NC
451 Ruin Creek Road Suite 202
Henderson, NC 27536
Phone: 252-438-4426
Fax: 252-430-1709
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Rockville, MD (North Bethesda)
11801 Rockville Pike Suite 105
Rockville, MD 20852
Phone: 301-881-6222
Fax: 301-881-1639
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Kensington, MD
10901 Connecticut Avenue Suite 200
Kensington, MD 20895
Phone: 301-949-2000
Fax: 301-949-2002
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Rockville, MD (Shady Grove Rd)
15215 Shady Grove Rd Suite 307
Rockville, MD 20850
Phone: 240-268-7450
Fax: 301-949-8833
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Chevy Chase, MD
5530 Wisconsin Avenue Suite 945
Chevy Chase, MD 20815
Phone: 301-913-5225
Fax: 301-913-9145
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Silver Spring, MD (International Drive)
3801 International Drive Suite 204
Silver Spring, MD 20906
Phone: 301-598-0130
Fax: 301-598-5091
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Clarksville, MD
6100 Day Long Lane Suite 208
Clarksville, MD 21029
Phone: 443-535-8770
Fax: 443-535-8775
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Apex, NC
1001 Pemberton Hill Road Suite 102
Apex, NC 27502
Phone: 919-363-3310
Fax: 919-363-3370
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Concord, NC
492 Copperfield Blvd NE
Concord, NC 28025
Phone: 704-788-9797
Fax: 704-788-6830
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University, NC
8310 Medical Plaza Drive Suite E
Charlotte, NC 28262
Phone: 704-548-0222
Fax: 704-548-1157
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Ballantyne, NC
9216 Ardrey Kell Road Suite 100
Charlotte, NC 28277
Phone: 704-544-6517
Fax: 704-544-2988
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Frederick, MD (Solarex Ct)
604 Solarex Court Suite 103
Frederick, MD 21703
Phone: 301-698-9260
Fax: 301-698-8962
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Greencastle, PA
50 Eastern Ave Suite 122
Greencastle, PA 17225
Phone: 717-643-0795
Fax: 717-643-0833
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Hagerstown, MD
11110 Medical Campus Road Suite 100
Hagerstown, MD 21742
Phone: 301-739-1575
Fax: 301-739-1578
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Gettysburg, PA
506 W. Middle Street
Gettysburg, PA 17325
Phone: 717-778-3338
Fax: 717-778-3340
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Wake Foot & Ankle – Wake Forest
833C Wake Forest Business Park
Wake Forest, NC 27587
Phone: 919-230-7233
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Alleghany, VA
1 ARH Lane Suite 101
Low Moor, VA 24457
Phone: 540-344-3668
Fax: 540-774-4615
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Roanoke, VA
222 Walnut Avenue SW
Roanoke , VA 24016
Phone: 540-344-3668
Fax: 540-343-2457
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Salem, VA
1802 Braeburn Drive Suite A2130
Salem, VA 24153
Phone: 540-344-3668
Fax: 540-774-4615
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Charlotte, NC (Pineville)
10370 Park Rd. #100
Charlotte, NC 28210
Phone: 704-542-8253
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Private: Benson, NC
1 Medical Drive
Benson, NC 27504
Phone: 919-363-3310
Fax: 919-363-3370
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Matthews, NC
534 West John St. Suite 100
Matthews, NC 28105
Phone: 704-847-9788
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Waxhaw, NC
323 N. Broome St.
Waxhaw, NC 28173
Phone: 704-847-9788
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Lincolnton, NC
626 Clark Dr.
Lincolnton, NC 28092
Phone: 704-847-9788
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Pasadena, MD
8155 Ritchie Highway Suite B
Pasadena, MD 21122
Phone: 410-768-5800
Fax: 410-768-5806
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Harrisburg, NC
3800 Highway 49 South
Harrisburg, NC 28075
Phone: 704-455-2999
Fax: 704-455-1624
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Columbia, MD
11055 Little Patuxent Pkwy Suite 204
Columbia, MD 21044
Phone: 410-730-2623
Fax: 410-992-4779
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Fairfax, VA (Hamaker Court)
3020 Hamaker Court Suite 201
Fairfax, VA 22031
Phone: 703-207-0073
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Annapolis, MD
129 Lubrano Drive Suite 303
Annapolis, MD 21401
Phone: 410-266-7575
Fax: 410-266-7366
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Colonial Heights, VA
4720 Puddledock Road Suite 120
Prince George, VA 23875
Phone: 804-320-3668
Fax: 844-468-5770
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Richmond, VA
1465 Johnston Willis Drive
Richmond, VA 23235
Phone: 804-320-3668
Fax: 844-468-5770
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Silver Spring, MD (White Oak)
2415 Musgrove Road Suite 103
Silver Spring, MD 20904
Phone: 301-384-6500
Fax: 301-384-6670
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Alpine Podiatry – Fort Mill
105 Ben Casey Drive, Suite 133
Fort Mill, SC 29708
Phone: (803) 396-8670
Fax: (803) 396-8657
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Huntersville, NC
16419 Northcross Dr Suite A
Huntersville, NC 28078
Phone: 704-987-9585
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Harrisburg, PA
4033 Linglestown Road Suite 1
Harrisburg, PA 17112
Phone: 717-651-0000
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Hampton, VA
2210 Executive Drive Suite E
Hampton, VA 23666
Phone: 757-896-8800
Fax: 757-896-8832
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Newport News, VA
754 McGuire Place
Newport News, VA 23601
Phone: 757-599-5710
Fax: 757-591-0552
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Greenbelt, MD
7501 Greenway Center Dr Suite 810
Greenbelt, MD 20770
Phone: 301-577-4464
Fax: 301-577-4702
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Mountain Island, NC
10310 Couloak Drive Suite 200
Charlotte, NC 28216
Phone: 704-971-4000
Fax: 704-971-2379
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Mechanicsburg, PA
2025 Technology Parkway Suite 201
Mechanicsburg, PA 17050
Phone: 717-651-0000
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Gaithersburg, MD
702 Russell Avenue, Suite 103 PNC Bank Building
Gaithersburg, MD 20877
Phone: (301) 948-3668
Fax: (301) 926-7787
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Newport, PA
300 Bretz Ct
Newport, PA 17074
Phone: 717-651-0000
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Martinsville, VA
1 Dudley Street
Martinsville, VA 24112
Phone: 540-344-3668
Fax: 540-774-4615