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Heel Pains: Is it a spur or something else?
By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
We are often told that the cause of our heel pain is a spur. It turns out that spurs do not cause heel pain as much as we think. One of the most common causes of heel pain is a problem called “plantar fasciitis.”
Plantar fasciitis is the term doctors use when a part of the foot called the plantar fascia gets irritated or swollen. The plantar fascia is a tough band of tissue that connects the heel bone to the toes. It is usually inflamed when we get heel spurs and is most often the reason for our heel pain. 
Today we will shed some light on plantar fasciitis, which may be the most likely cause if you ever develop heel pains.
WHAT ARE SYMPTOMS OF PLANTAR FASCIITIS?
Pain and swelling are the main symptoms of plantar fasciitis. Pain may be worse in the morning or when you put pressure on your heel and it can make walking painful. It may be dull or sharp, depending on the time of day and what you’re doing. It can become very excruciating and even run up the ankle.
WHAT CAUSES PLANTAR FASCIITIS?
As you age, the plantar fascia becomes less like a rubber band and more like a rope that doesn’t stretch as well. The fat pad on your heel becomes thinner and can’t absorb as much shock. The extra shock can damage the plantar fascia and may cause it to swell, bruise, or tear. Most people also have pain to some degree. Repeated impact on the heel, like from running, walking, or standing, also can cause plantar fasciitis. Patients can develop spurs in a similar way and this can irritate the plantar fascia causing pains to the heel.
HOW IS PLANTAR FASCIITIS DIAGNOSED?
Your doctor can often diagnose you by examining you and talking to you. He or she will want to know about your pain, when it occurs, and how long you’ve had it. Your doctor may order tests to make sure the pain is not caused by another problem. These tests could include an X-ray or magnetic resonance imaging (MRI).
HOW IS PLANTAR FASCIITIS TREATED?
In most cases, your doctor will start with basic treatments that can be done at home. These may vary depending on the cause of your pain.
· If you walk or run a lot, you may need to cut back. Ask your doctor how much exercise you should do.
· If you have high arches, talk to your doctor about using shoe inserts called orthotics. These help to support your arches. You will need to be fitted for them.
· If you are overweight or obese, losing weight can help reduce pressure on your heels.
· If your job involves standing for long periods of time, place some type of padding on the floor where you stand.
· You also may try orthotics to provide extra cushion to your heels.
Stretching exercises for your feet and legs are important. There are various stretching exercises for your foot and legs that you can find on you tube. Just type in “plantar fasciitis stretches” and helpful videos should appear.
· Strengthening exercises are important as well. You can strengthen your leg muscles by standing on the ball of your foot at the edge of a step and rising up onto your toes as high as possible. Relax between toe raises and let your heel fall a little lower than the edge of the step. You can strengthen your foot muscles by grabbing a towel with your toes as if you are going to pick it up with your foot. Repeat these exercises several times a day.
· Anti-inflammatory medicines such as naproxen, ibuprofen and diclofenac, can help reduce swelling and pain. Talk to your doctor before you start a new medicine. Most cases of plantar fasciitis go away over time.
For best results, try to be consistent in your treatment approaches. If these do not work, your doctor may suggest other options, such as:
· Physiotherapy.
· Splints on your foot at night.
· Tape on your foot.
· Steroid injections into the plantar fascia.
In rare cases, you may need surgery. Talk to your doctor about the benefits and risks of these treatments.
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