Materiały źródłowe

• #1 Plantar Heel Pain – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499868/

  Plantar heel pain is a pervasive issue that afflicts numerous adults and significantly hampers their quality of life. With diverse causative factors, ranging from common plantar fasciitis to more complex etiologies such as S1 radiculopathy and seronegative spondyloarthropathies, this activity comprehensively explores the condition. This condition underscores the pivotal role of an interprofessional team in recognizing and managing plantar heel pain effectively. The program facilitates a practical approach to identifying the underlying cause through comprehensive history-taking and physical examination, which form the foundation of accurate diagnosis. The activity discusses evidence-based management strategies, encompassing lifestyle modifications, nonsteroidal anti-inflammatory drugs, rehabilitation, local injections, and surgical interventions. By participating in this activity, learners will be better prepared to address the challenges posed by plantar heel pain and improve patient outcomes through a comprehensive and interdisciplinary approach.

• #1 Heel Pain: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0115/p86.html

  The differential diagnosis of heel pain is extensive, but a mechanical etiology is the most common. The specific anatomic location of the pain can help guide diagnosis. The most common diagnosis is plantar fasciitis, which leads to medial plantar heel pain, especially with the first weight-bearing steps after rest. […] Heel pain is a common presenting symptom to family physicians and has an extensive differential diagnosis. Most diagnoses stem from a mechanical etiology. […] The anatomic location of the pain can be a guide to diagnosis. […] More than 2 million persons present with plantar heel pain every year. Plantar fasciitis is the most common cause, with a lifetime prevalence of 10% in the general population. The primary symptom is usually throbbing medial plantar heel pain that is worse with the first steps after rest.

• #1 Plantar Fasciitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431073/

  Plantar fasciitis, a prevalent and often vexing condition, arises from the degenerative irritation of the plantar fascia origin at the medial calcaneal tuberosity of the heel and its surrounding perifascial structures. […] An absence of inflammatory cells characterizes this condition despite its name. […] While multifactorial in its origins, overuse stress is often the leading cause, presenting with sharp localized pain at the heel and, occasionally, a heel spur. […] Plantar fasciitis occurs due to degenerative irritation at the origin of the plantar fascia, located at the medial calcaneal tuberosity of the heel and the surrounding perifascial structures. […] The fascia is essential in supporting the arch and providing shock absorption. Despite featuring the -itis suffix in the diagnosis, this condition stands out for its absence of inflammatory cells.

• #1 Plantar Fasciitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431073/

  The cause of plantar fasciitis is multifactorial, but most cases result from overuse stress. […] This condition is primarily a degenerative process. […] Aside from degenerative changes, histological findings include granulation tissue, micro-tears, collagen disarray, and a notable lack of traditional inflammation. […] Microtears occur due to the repetitive stress of standing upright and bearing weight, initiating the condition. […] The constant stretching of the plantar fascia results in chronic degeneration of the fascia, eventually leading to pain during sleep or at rest.

• #1 Plantar Heel Pain – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499868/

  Repetitive microtrauma is the classic cause of plantar fasciitis and can be exacerbated by obesity, prolonged standing, pes planus, soleus-gastrocnemius complex dysfunction, and ankle instability. The windlass mechanism describes how, when under tension, the plantar fascia pulls the midtarsal bones together into a stable, longitudinal arch that locks the midfoot and supports the axial load. Failure of this relationship, from repetitive microtrauma or excessive load, can result in a collapsed arch and variable foot pain. Furthermore, aging leads to a reduction in the elasticity of the plantar fascia. These factors may contribute to the progressive degeneration of the soft tissue and failure of the windlass mechanism. […] The heel pad comprises closely packed fat chambers surrounded by tough circular or cone-shaped collagenous septa and elastin fibers. Reduction in fat chambers may be due to micro-trauma or repeated corticosteroid injections leading to decreased shock-absorbing properties and the development of pain. A decrease in the height of the fat pad may contribute to heel pain.

• #1 Diagnosis of Heel Pain | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1015/p909.html

  Heel pain that is accompanied by burning, tingling, or numbness may suggest a neuropathic etiology. These symptoms most commonly indicate nerve entrapment caused by overuse, trauma, or injury from previous surgery. […] Pain from heel pad syndrome is often erroneously attributed to plantar fasciitis. Patients with heel pad syndrome present with deep, bruise-like pain, usually in the middle of the heel, that can be reproduced with firm palpation. […] Achilles tendinopathy is usually caused by running, wearing high heels, and other activities associated with overuse of the calf muscles. […] A Haglund deformity is a prominence of the superior aspect of the posterior calcaneus. The condition can occur in anyone, but is most common in women who are in their twenties. […] Sever disease (calcaneal apophysitis) is the most common etiology of heel pain in children and adolescents, usually occurring between five and 11 years of age. Bones grow quicker than the muscles and tendons in these patients. […] Although less common, other tendinopathies can cause heel pain localized to the insertion site of the affected tendon.

• #1 Plantar Heel Pain – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499868/

  Normal weight-bearing stress is less than the threshold to cause a calcaneal fracture. Stress fractures are most commonly found posterior and inferior to the posterior facet of the subtalar joint. Patients with osteopenia or who play a sport with repetitive jumping or running are at higher risk for this injury. Abnormal mechanical stress results in inadequate bone healing, osteoclast activation, and thus stress fracture. Other relevant factors include starting a new activity (running) and increased intensity or duration of previous activities (prolonged running and standing), obesity, inappropriate footwear, flat feet, and rheumatoid arthritis. Aside from mechanical load, intrinsic factors of bone secondary to bone tumors (Ewing sarcoma) or metastatic disease (endometrial adenocarcinoma, bronchogenic carcinoma, bladder cancer, and gastric cancer) can result in a pathologic calcaneal fracture.

• #1 Plantar Fasciitis: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/86143-overview

  During running, the vertical forces in the foot at foot strike may reach 2-3 times an individuals body weight. […] The plantar fascia and longitudinal arch are also part of the foots shock absorption mechanism. During the heel-off phase of gait, tension increases on the plantar fascia, which acts as a storage of potential energy. During toe-off, the plantar fascia passively contracts, converting the potential energy into kinetic energy and imparting greater foot acceleration.

• #1 Plantar Fasciitis: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/86143-overview

  Plantar fasciitis is the pain caused by degenerative irritation at the insertion of the plantar fascia on the medial process of the calcaneal tuberosity. […] The etiology of this condition is multifactorial, and the condition can occur traumatically; however, most cases are from overuse stresses. […] Biomechanical dysfunction of the foot is the most common etiology of plantar fasciitis; however, infectious, neoplastic, arthritic, neurologic, traumatic, and other systemic conditions can prove causative. The pathology is traditionally believed to be secondary to the development of microtrauma (microtears), with resulting damage at the calcaneal-fascial interface secondary to repetitive stressing of the arch with weight bearing. […] Excessive stretching of the plantar fascia can result in microtrauma of this structure either along its course or where it inserts onto the medial calcaneal tuberosity. This microtrauma, if repetitive, can result in chronic degeneration of the plantar fascia fibers.

• #1 Plantar Fasciitis: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/86143-overview

  The term fasciitis may, in fact, be something of a misnomer, because the disease is actually a degenerative process that occurs with or without inflammatory changes, which may include fibroblastic proliferation. […] Studies have introduced the etiologic concept of fasciosis as the inciting pathology. Fasciosis, like tendinosis, is defined as a chronic degenerative condition that is characterized histologically by fibroblastic hypertrophy, absence of inflammatory cells, disorganized collagen, and chaotic vascular hyperplasia with zones of avascularity. […] These changes suggest a noninflammatory condition and dysfunctional vasculature, which may be seen on ultrasound. […] With reduced vascularity and a compromise in nutritional blood flow through the impaired fascia, it becomes difficult for cells to synthesize the extracellular matrix necessary for repairing and remodeling.

• #1 Plantar Heel Pain: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1233178-overview

  The heel pain can also have a neurologic basis. The tibial nerve, with nerve roots from L4-5 and S2-4, courses in the medial aspect of the hindfoot, through the tarsal tunnel, under the flexor retinaculum, and over the medial surface of the calcaneus. The calcaneal branch, arising directly from the tibial nerve, carries sensation from the medial and plantar heel dermis. […] The tibial nerve divides into lateral and medial plantar nerves, which proceed into the plantar aspect of the foot through a foramen within the origin of the abductor hallucis muscles, which forms the distal tarsal tunnel. The first branch of the lateral plantar nerve changes course from a vertical to a horizontal direction around the medial plantar heel. It passes deep to the abductor hallucis muscle fascia and the plantar fascia and is the nerve supply to the abductor digiti minimi. The tibial nerve and its branches in the hindfoot can be involved with compressive neuropathies. A valgus heel can stretch in the tibial nerve.

• #1 Plantar Heel Pain – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499868/

  Tarsal tunnel syndrome is due to the entrapment of the tibial nerve underneath the flexor retinaculum on the medial side of the ankle. Entrapment may be due to direct nerve compression from any space-occupying lesion, including an accessory flexor digitorum longus, a soft tissue mass such as a ganglion cyst, or fibrous scar tissue from prior surgery. The cause may be more elusive and result from systemic inflammation in diabetes mellitus and rheumatoid arthritis or be idiopathic. […] The medial calcaneal nerve commonly arises from the tibial nerve above the level of the flexor retinaculum of the ankle. This nerve carries sensory information from the skin over the plantar surface of the calcaneus and subcutaneous fat. The entrapment of this nerve might be due to tight fascia, varicosities, or scars from previous surgical procedures. The Baxter nerve is the first branch of the lateral plantar nerve. This nerve provides motor innervation to the quadratus plantae, flexor digitorum brevis, and abductor digiti minimi muscles. This nerve also carries sensory information from the calcaneal periosteum and the long plantar ligament. Baxter nerve can be entrapped distally due to tight fascial planes, muscle hypertrophy, or compression secondary to foot biomechanics.

• #1

  https://www.southtexaspodiatrist.com/blog/common-causes-of-heel-pain-5

  Baxter’s neuritis or plantar nerve entrapment is a condition that occurs when the plantar nerve, which runs along the bottom of the foot, becomes compressed or irritated, leading to heel pain. […] The goal of treatment of Baxter’s neuritis is desensitization of the nerve. Use of radiofrequency ablation in the office is one of the most successful methods.

• #1 Heel Pain: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0115/p86.html

  Calcaneal stress fractures are caused by repetitive overload to the heel and most commonly occur immediately inferior and posterior to the posterior facet of the subtalar joint. Pain usually begins after an increase in weight-bearing activities or after changing to a harder walking surface. […] Heel pain accompanied by burning, tingling, or numbness may suggest a neuropathic etiology, either with nerve entrapment or the development of a neuroma. […] Pain from heel pad syndrome is described as a deep, bruise-like pain, usually in the middle of the heel, and can be reproduced with firm palpation. […] The Achilles tendon is formed from the merging of the soleus and gastrocnemius muscles, and it inserts into the calcaneus. Excessive mechanical loading of the muscle, such as with increased running, can cause tendinopathy that leads to posterior heel pain.

• #1 Heel pain Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/heel-pain.html

  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. […] Achilles tendonitis is triggered by overuse, especially by excessive jumping during sports. […] Compression of a small nerve (a branch of the lateral plantar nerve) can cause pain, numbness or tingling in the heel area.

• #1 Heel Pain – Causes, Symptoms and Treatment | Sanders Podiatry Adelaide

  https://sanderspodiatry.com.au/blog/2020/04/21/heel-pain-causes-symptoms-and-treatment/

  Plantar fasciitis is the most common cause of heel pain. It is an inflammation of the plantar fascia, the band of tissue that runs underneath the foot forming the arch, connecting the heels to the toes. Plantar Fasciitis occurs through overuse and strain of the feet which causes small tears in the plantar fascia and therefore inflammation. […] A heel spur is a bony projection at the area where the plantar fascia attaches to the heel bone. They occur through constant and repetitive strain on the plantar fascia and muscles of the foot. Heel spurs themselves are not painful but they can cause pain when pulling on the planta fascia. […] Bursitis is the inflammation of these bursa, caused by an abnormal gait or shoes that dont have enough heel cushioning. […] Achilles tendonitis is the inflammation of the Achilles tendon, the tendon that attaches your heel to your calf muscle. When exposed to excessive overuse, the tendon can be damaged and cause pain in the Achilles tendon around 2-5cms above the heel. […] A small plantar nerve in the heel can become trapped and cause significant pain. Unlike plantar fasciitis, plantar nerve impingement causes chronic pain even when your feet are up. […] There may be other causes of heel pain that may start from your ankles, knees, hips and back alignment.

• #1 Sever’s Disease (Heel Pain) – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/severs-disease/

  Sever’s disease (also known as calcaneal apophysitis) is one of the most common causes of heel pain in growing children, especially children who are very physically active. It is an inflammation of the growth plate in the calcaneus (heel). […] Sever’s disease is caused by repetitive stress to the heel. It most often occurs during growth spurts, when bones, muscles, tendons, and other structures are changing rapidly. […] Repetitive stress from running, jumping, and other high-impact activities can cause pain and inflammation in this growth area of the heel. Additional stress from the pulling of the Achilles tendon at its attachment point can sometimes further irritate the area.

• #1 Heel Pain: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0115/p86.html

  A Haglund deformity is a prominence of the superior aspect of the posterior calcaneus that is most common in middle-aged women. […] The most common etiology of heel pain in children and adolescents is Sever disease (calcaneal apophysitis). […] Other, less common tendinopathies can cause heel pain localized to the insertion site of the affected tendon. […] Compression of the posterior tibial nerve through the tarsal tunnel causes burning, tingling, shooting pain, or numbness in the posteromedial ankle and heel. […] Sinus tarsi syndrome can be caused by a single traumatic event, repeated lateral ankle sprains, or repeated hyperpronation of the foot, leading to instability of the subtalar joint.

• #1 Foot problems – heel pain | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/foot-problems-heel-pain

  The heel is a padded cushion of fatty tissue that holds its shape despite the pressure of body weight and movement. […] Common causes of heel pain include obesity, ill-fitting shoes, running and jumping on hard surfaces, abnormal walking style, injuries and certain diseases. […] Plantar fasciitis is inflammation of the ligament that runs the length of the foot, commonly caused by overstretching. It results in pain under the heel, particularly after rest. […] A heel spur is a bony growth that is not usually painful to the touch. […] Severs disease is caused by stress on the growth plate in the heel bone. […] Bruising or overstretching this ligament can cause inflammation and heel pain. […] A common cause is flat feet, because the ligament is forced to overstretch as the foot spreads out and the arch flattens.

• #1 Foot problems – heel pain | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/foot-problems-heel-pain

  In many cases, plantar fasciitis is associated with heel spur. […] An abnormal walking style, such as rolling the feet inwards, can place extra strain on the plantar fascia. […] Chronic inflammation may develop and, over time, lead to a bony growth or spur. […] The spur itself does not cause the pain, but pain may be associated with inflammation in the area. […] Severs disease results from stress placed on the growth plate of the heel bone. […] An excessive amount of running or jumping causes inflammation to the growth plate, which results in pain.

• #1 Heel Pain – APMA MAIN

  https://www.apma.org/heelpain/

  Heel pain is generally the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. […] Heel spurs result from strain on the muscles and ligaments of the foot, by stretching of the long band of tissue that connects the heel and the ball of the foot, and by repeated tearing away of the lining or membrane that covers the heel bone. […] The condition occurs when the plantar fascia is strained over time beyond its normal extension, causing the soft tissue fibers of the fascia to tear or stretch at points along its length; this leads to inflammation, pain, and possibly the growth of a bone spur where the plantar fascia attaches to the heel bone. […] Excessive pronation may also contribute to injury to the hip, knee, and lower back.

• #1 Plantar Heel Pain: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1233178-overview

  Dorsiflexion of the toes applies traction stress at the origin of the plantar fascia. A contracture in the triceps surae, a pes cavus, or a pes planus can increase the traction load at the origin of the plantar fascia during weightbearing activities. […] Other anatomic factors that can have similar effects are overpronation, discrepancy in leg length, excessive lateral tibial torsion, and excessive femoral anteversion. However, overuse, not anatomy, is the most common cause of plantar fasciitis in athletes. The pain of plantar fasciitis is caused by collagen degeneration associated with repetitive microtrauma to the plantar fascia. […] An inflammatory response and reparative process can double the thickness of the plantar fascia, which is normally approximately 3 mm. Biopsy specimens reveal collagen necrosis, angiofibroblastic hyperplasia, chondroid metaplasia, and calcification.

• #1 Heel pain: Causes, prevention, and treatments

  https://www.medicalnewstoday.com/articles/181453

  Heel pain can result from factors like inflammation, bone changes, and nerve compression. It occurs under the heel or just behind it, where the Achilles tendon connects to the heel bone. Sometimes, it can affect the side of the heel. […] Pain that occurs under the heel is likely due to plantar fasciitis. This is the most common cause of heel pain. Pain behind the heel is most likely Achilles tendinitis. Pain can also affect the inner or outer side of the heel and foot. […] Heel pain may occur due to a single injury, such as a twist or fall, or from repetitive stress and pounding of the heel. […] Common causes of heel pain include: […] This is inflammation of the plantar fascia. The plantar fascia is a strong, bowstring-like ligament that runs from the calcaneum, or heel bone, to the tip of the foot.

• #1 Heel Pain: Causes, Treatments, and Prevention

  https://www.healthline.com/health/heel-pain

  Reactive arthritis: An infection in the body triggers this type of arthritis. […] If your pain is severe, your doctor may provide you with anti-inflammatory medications. These medications can be injected into the foot or taken by mouth. […] In very rare cases, your doctor may recommend surgery to correct the problem, but heel surgery often requires a long recovery time and may not always relieve your foot pain.

• #1 Plantar Fasciitis > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/plantar-fasciitis

  The body attempts to heal the injured tissue by mounting an inflammatory response. That, technically, is the inflammation people talk about, meaning new blood flowing to try and heal the degenerative area, he says. […] The main cause of plantar fasciitis, Dr. Peden says, is having tightness in your gastrocnemius, one of two major muscles in your calf. […] Tightness of the Achilles tendon, a tough band of tissue that connects the calf muscles to the heel bone, is also commonly associated with plantar fasciitis. […] If the tissue of the plantar fascia has degenerative strain on the fibers, that tightens it even more, so when you put your weight on it in the morning and stretch it out, you are standing on and stretching out partially torn tissue, Dr. Peden explains. […] The first treatments for plantar fasciitis are conservative and involve simple steps like stretching your foot, calf, and Achilles tendon.

• #1 Plantar Fasciitis > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/plantar-fasciitis

  A splint worn at night will hold your foot at a 90-degree angle and allow the plantar fascia to stretch while you sleep. […] However, if simple treatments dont work and the pain is limiting your lifestyle, your doctor may recommend a cortisone shot to the plantar fascia, which reduces the pain. […] He notes that the root cause is often an extremely tight gastrocnemius (calf muscle). For those patients, a surgery to lengthen the gastrocnemius may be able to address the problem.

• #1 Plantar Fasciitis: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/fitness-exercise/understanding-plantar-fasciitis-basics

  If you do, it suggests that you have had tension on your plantar fascia for a while. This happens quite often with plantar fasciitis, although it doesn’t usually cause symptoms itself. […] Cortisone is a powerful anti-inflammatory that can relieve your pain and inflammation. But your doctor may be cautious when using this because it can cause a tendon rupture or tear in your plantar fascia, which may cause your arch to fall and cause chronic pain. […] Platelet-rich plasma is taken from your own blood and injected into your plantar fascia. This seems to help the plantar fascia heal, and it doesn’t have the same risk for tendon rupture that cortisone injections have. However, this is still an experimental procedure, and more research is needed to understand how it works. […] During a gastrocnemius release, one of the muscles in your ankle (gastrocnemius) is lengthened to take pressure off your plantar fascia. During a partial plantar fascia release, the surgeon makes a partial cut in your fascia to take the tension off your muscle.

• #1 Heel Pain – Harvard Health

  https://www.health.harvard.edu/a_to_z/heel-pain-a-to-z

  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 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. […] 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.

• #1

  https://www.southtexaspodiatrist.com/blog/common-causes-of-heel-pain-5

  Plantar fasciitis is the most common cause of heel pain. It occurs when the plantar fascia, a thick band of tissue that runs along the bottom of the foot, becomes inflamed. The plantar fascia connects the heel bone to the toes and supports the arch of the foot. When the foot experiences excessive strain or pressure, the plantar fascia can become strained, irritated or damaged, leading to inflammation and pain. […] Chronic plantar fasciitis can become excruciating, leading to heel spurs or even stress fractures, prolonging recovery time and leading to further complications. Treatment needs to focus on eliminating the causes as opposed to treating the symptoms. […] Rheumatoid Arthritis (RA) is a chronic autoimmune disorder that can affect many parts of the body, including the feet. According to numerous studies, RA is one of the leading causes of heel pain. In RA, the immune system mistakenly attacks healthy tissues around the joints, leading to inflammation in the area.

• #1

  https://www.southtexaspodiatrist.com/blog/common-causes-of-heel-pain-5

  Proper diagnosis and treatment of RA are essential in managing the symptoms of heel pain caused by RA. Pain management, through medication, physical therapy, exercise, and wearing supportive shoes, can greatly improve quality of life and prevent further damage to the joints and tissues. […] Tarsal Tunnel Syndrome (TTS) is a condition that occurs when the nerves in the tarsal tunnel, a narrow passage located in the ankle, become compressed or irritated. […] TTS is one of the leading causes of heel pain and is often described as a burning, tingling, or shooting pain that radiates from the heel to the toes. […] Treatment options for TTS usually include rest, anti-inflammatory medication, stretching exercises, physical therapy, orthotics, or in severe cases, surgery may be required. TTS is a manageable condition when diagnosed early and managed effectively.

• #2 Plantar Heel Pain – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499868/

  As a common problem among adults, plantar heel pain can lead to significant disability and impairment of activities of daily living. Plantar heel pain can be due to local causes, which include plantar fasciitis, referred causes like S1 radiculopathy or systemic illnesses, such as seronegative spondyloarthropathies. The most common causes of plantar heel pain are plantar fasciitis, heel fat pad atrophy, calcaneal stress fracture, or entrapment of the tibial nerve, medial calcaneal nerve, or the first branch of the lateral plantar nerve (Baxter nerve). History taking and physical examination are crucial for correct diagnosis. Laboratory studies can help diagnose systemic causes of plantar heel pain. Plain radiographs and computed tomography can confirm the diagnosis of the stress fractures of the calcaneus and bone tumors. High-resolution ultrasound confirms the diagnosis of plantar fasciitis, heel fat pad atrophy, or entrapment neuropathies. Electrophysiological studies are required to investigate neurogenic causes of plantar heel pain. Magnetic resonance imaging can also help diagnose soft tissue pathologies and may be better than ultrasound for investigating bony disorders. Treatments include lifestyle modification, non-steroidal anti-inflammatory drugs, rehabilitation, local injection, and surgery.

• #2 Heel pain

  https://www.mayoclinic.org/symptoms/heel-pain/basics/causes/sym-20050788

  The most common causes of heel pain are plantar fasciitis, which affects the bottom of the heel, and Achilles tendinitis, which affects the back of the heel. […] Heel pain also may be caused by other chronic conditions, injuries or some medical conditions that affect the bones and joints. […] Causes of heel pain include: […] Chronic conditions that can cause heel pain include Achilles tendinitis, bursitis, Haglund’s deformity, heel spur, peripheral neuropathy, plantar fasciitis, plantar warts, retrocalcaneal bursitis, and tarsal tunnel syndrome. […] Injuries that can cause heel pain include Achilles tendon rupture, calcaneal fracture, heel bruise, also called contusion, and stress fractures. […] Medical conditions that can cause heel pain include ankylosing spondylitis, bone tumor, osteomyelitis, Paget’s disease of bone, pinched nerve, psoriatic arthritis, reactive arthritis, rheumatoid arthritis, and sarcoidosis.

• #2 Plantar Fasciitis: Symptoms, Causes & Treatment Options

  https://my.clevelandclinic.org/health/diseases/14709-plantar-fasciitis

  Plantar fasciitis is inflammation in the plantar fascia in your foot. Its the most common cause of heel pain. […] Plantar fasciitis happens when your plantar fascia is overused or stretched too far. Anything that damages your plantar fascia can make it swell. This inflammation makes it painful to walk or use your foot. […] Plantar fasciitis is extremely common. More than 2 million people in the U.S. are treated for it each year. […] Anything that irritates or damages your plantar fascia can cause plantar fasciitis, including: […] Some health conditions can cause plantar fasciitis, including: […] The most common treatments for plantar fasciitis include: […] Corticosteroids are anti-inflammatory medicines. Your provider might inject a corticosteroid (like prednisone) into your plantar fascia. […] Plantar fasciitis is the most common cause of heel pain.

• #2 Plantar fasciitis – Wikipedia

  https://en.wikipedia.org/wiki/Plantar_fasciitis

  Plantar fasciitis is a disorder of the insertion site of the ligament on the bone characterized by micro tears, breakdown of collagen, and scarring. […] The cause of plantar fasciitis is poorly understood and appears to have several contributing factors. […] Plantar fasciitis is a non-inflammatory condition of the plantar fascia. […] Within the last decade, studies have observed microscopic anatomical changes indicating that plantar fasciitis is due to a non-inflammatory structural breakdown of the plantar fascia rather than an inflammatory process. […] Repetitive microtrauma (small tears) appears to cause a structural breakdown of the plantar fascia. […] Disruptions in the plantar fascia’s normal mechanical movement during standing and walking (known as the Windlass mechanism) place excess strain on the calcaneal tuberosity and seem to contribute to the development of plantar fasciitis. […] Other studies have also suggested that plantar fasciitis is not due to the inflamed plantar fascia but maybe a tendon injury involving the flexor digitorum brevis muscle located immediately deep to the plantar fascia.

• #2 Plantar Fasciitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431073/

  The cause of plantar fasciitis is multifactorial, but most cases result from overuse stress. […] This condition is primarily a degenerative process. […] Aside from degenerative changes, histological findings include granulation tissue, micro-tears, collagen disarray, and a notable lack of traditional inflammation. […] Microtears occur due to the repetitive stress of standing upright and bearing weight, initiating the condition. […] The constant stretching of the plantar fascia results in chronic degeneration of the fascia, eventually leading to pain during sleep or at rest.

• #2 Plantar fasciitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846

  Plantar fasciitis is an inflammation of the fibrous tissue (plantar fascia) along the bottom of your foot that connects your heel bone to your toes. Plantar fasciitis can cause intense heel pain. […] Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of each foot and connects the heel bone to the toes, known as the plantar fascia. […] The cause of plantar fasciitis is poorly understood. It is more common in runners and in people who are overweight. […] Tension and stress on the fascia can cause small tears. Repeated stretching and tearing of the fascia can irritate or inflame it, although the cause remains unclear in many cases of plantar fasciitis.

• #2 13 Heel Pain Causes and How They’re Treated

  https://www.verywellhealth.com/heel-pain-information-and-causes-2549378

  Stress fractures of the heel commonly occur in athletes (such as long-distance runners) who overtrain or intensify their workouts over a short period of time. Repeated stress on the heel bone eventually causes a break. […] Heel pad syndrome is a related condition in which the thinning of the fat pad is caused by repetitive trauma. […] Sinus tarsi syndrome is usually caused by a traumatic injury, leading to ongoing pain in the front and sides of the ankle. […] Rare causes of heel pain include heel bone infection, which is a form of osteomyelitis (bone inflammation) that causes constant heel pain, often with fever and fatigue. […] Pain is the common symptom among conditions that cause heel pain, but when and where it occurs helps to differentiate the exact cause. […] Treatment depends entirely on the cause of your heel pain.

• #2 The Royal College of Podiatry

  https://rcpod.org.uk/common-foot-problems/heel-pain

  Heel pain is a common occurrence. In most cases the pain is caused by some form of mechanical injury resulting from small repetitive injuries that occur at a rate faster than the body can heal them. […] Heel pain can also be caused by lower back problems or inflammatory joint conditions. […] This is the most common form of heel pain, caused by damage to the fascia band (similar to a ligament) which connects the heel bone to the base of the toes. […] This condition can be caused in various ways including extensive running, walking or standing for long periods of time, especially when you have a sedentary lifestyle. […] In particular, a change of surface (eg road to track), poor shoe support, being overweight, overuse or sudden stretching of your sole, as well as a tight Achilles tendon, can lead to this condition.

• #2 Heel Pain: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0115/p86.html

  Calcaneal stress fractures are caused by repetitive overload to the heel and most commonly occur immediately inferior and posterior to the posterior facet of the subtalar joint. Pain usually begins after an increase in weight-bearing activities or after changing to a harder walking surface. […] Heel pain accompanied by burning, tingling, or numbness may suggest a neuropathic etiology, either with nerve entrapment or the development of a neuroma. […] Pain from heel pad syndrome is described as a deep, bruise-like pain, usually in the middle of the heel, and can be reproduced with firm palpation. […] The Achilles tendon is formed from the merging of the soleus and gastrocnemius muscles, and it inserts into the calcaneus. Excessive mechanical loading of the muscle, such as with increased running, can cause tendinopathy that leads to posterior heel pain.

• #2 Diagnosis of Heel Pain | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1015/p909.html

  Heel pain is a common presenting symptom in ambulatory clinics. There are many causes, but a mechanical etiology is most common. Location of pain can be a guide to the proper diagnosis. The most common diagnosis is plantar fasciitis, a condition that leads to medial plantar heel pain, especially with the first weight-bearing steps in the morning and after long periods of rest. […] Plantar fasciitis is the most common cause of plantar heel pain. Historically, plantar fasciitis was considered an inflammatory syndrome; however, recent studies have demonstrated a noninflammatory, degenerative process, leading some to use the term plantar fasciosis. Regardless, the condition usually stems from multiple causes and can be debilitating for the patient. […] A calcaneal stress fracture is usually caused by repetitive overload to the heel, and most commonly occurs immediately inferior and posterior to the posterior facet of the subtalar joint. Patients often report onset of pain after an increase in weight-bearing activity or change to a harder walking surface.

• #2 What’s Causing Your Heel Pain?: Eric Blanson, DPM: Sports Medicine

  https://www.pmcfootandankleclinic.com/blog/whats-causing-your-heel-pain

  When people think of foot pain, it’s common to picture the toes or ankle. Discomfort in the heel, however, shouldn’t be forgotten as it strikes about 2 million people each year and is responsible for approximately 15% of all foot issues. A number of conditions can contribute to this pain. […] In most cases, heel pain is caused by plantar fasciitis. This occurs when a thick band of elastic tissue called the plantar fascia, the ligament that connects from the heel to the toes, gets inflamed from overstretching. Some of the primary symptoms of this issue include stabbing pain in your heel and pain when you first get out of bed in the morning or after other periods of inactivity. […] Jumping and other types of overuse of the Achilles tendon can cause it to flare up and result in symptoms like heel pain and swelling, a limited range of motion, and tight calf muscles.

• #2 13 Heel Pain Causes and How They’re Treated

  https://www.verywellhealth.com/heel-pain-information-and-causes-2549378

  The condition is also referred to as plantar fasciopathy because it’s a degenerative process that leads to secondary inflammation. […] If plantar fasciitis persists for a long time, a bony protrusion called a heel spur can form where the fascia connects to your heel bone. The pain from a heel spur is often described as cutting or stabbing. […] Achilles tendonitis is inflammation of the Achilles tendon, the large, cord-like tendon that attaches the back of your heel bone to the calf muscle. It causes tightening or burning pain in the tendon just over the heel. […] Achilles tendonitis is usually due to overuse, such as from long-distance running. […] In rare cases, the Achilles tendon can rupture. This typically occurs during vigorous physical activity when the foot suddenly pivots (such as with basketball or tennis).

• #2 Plantar Fasciitis > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/plantar-fasciitis

  Many people dread getting out of bed in the morningin particular those with plantar fasciitis, a condition characterized by stabbing pain in the heel that tends to be most intense when you take your first steps of the day. […] Too much stress, which can be caused by running, dancing, standing for long periods on your feet on a hard surface, improper shoes, obesity, and other factors, can lead to irritation and tiny tears in the plantar fascia. That damage, or degeneration, stiffens the plantar fascia and causes pain that is most often felt in the bottom of the heel. […] The plantar fascia is designed to absorb impact we place on our feet, but too much impact or strain can damage or tear its tissue. […] Furthermore, the term fasciitiswhich means inflammation of the fasciais not accurate, Dr. Peden says. Its actually fasciosis, because when you look at the fascia microscopically in these cases, its not inflammation of the tissue, but tiny tears and inappropriate healing. In an effort to heal those small tears, the plantar fascia thickens, much like a scar on the skin, Dr. Peden adds.

• #2 What’s Causing Your Heel Pain?: Eric Blanson, DPM: Sports Medicine

  https://www.pmcfootandankleclinic.com/blog/whats-causing-your-heel-pain

  Tarsal tunnel syndrome occurs when the foot’s posterior tibial nerve is compressed because of an injury, bone spur, or inflammation of the tendon. Symptoms can include general foot pain, heel pain that cycles between constant or shooting, a burning sensation near the heel, and/or a feeling of numbness at the base of the foot. […] Osteoarthritis and other degenerative conditions can cause damage in your heel joints that may result in bone spurs when the body adds new bone material to the existing bone to try to heal it. You may experience joint pain and stiffness, muscle weakness, and/or nerve pain. […] Repetitive overuse or strenuous exercise can stress the heel bone and result in a fracture. Symptoms may include heel pain that is acute or chronic, swelling, bruising, and difficulty walking.

• #2

  https://www.southtexaspodiatrist.com/blog/common-causes-of-heel-pain-5

  Proper diagnosis and treatment of RA are essential in managing the symptoms of heel pain caused by RA. Pain management, through medication, physical therapy, exercise, and wearing supportive shoes, can greatly improve quality of life and prevent further damage to the joints and tissues. […] Tarsal Tunnel Syndrome (TTS) is a condition that occurs when the nerves in the tarsal tunnel, a narrow passage located in the ankle, become compressed or irritated. […] TTS is one of the leading causes of heel pain and is often described as a burning, tingling, or shooting pain that radiates from the heel to the toes. […] Treatment options for TTS usually include rest, anti-inflammatory medication, stretching exercises, physical therapy, orthotics, or in severe cases, surgery may be required. TTS is a manageable condition when diagnosed early and managed effectively.

• #2

  https://www.southtexaspodiatrist.com/blog/common-causes-of-heel-pain-5

  Baxter’s neuritis or plantar nerve entrapment is a condition that occurs when the plantar nerve, which runs along the bottom of the foot, becomes compressed or irritated, leading to heel pain. […] The goal of treatment of Baxter’s neuritis is desensitization of the nerve. Use of radiofrequency ablation in the office is one of the most successful methods.

• #2 Heel pain: a practical approach

  https://www.racgp.org.au/afp/2015/march/heel-pain-a-practical-approach

  The plantar fascia, histologically indistinguishable from a tendon, is also a common source of pain, especially in older women who are more obese. […] Pain from a neural source can mimic soft tissue pain. Neural sources of heel pain may include an entrapment that can occur proximally, for example, in the lower lumbar spine and gluteal region, or distally at the ankle retinacula. The posterior tibial nerve ends deep to the flexor retinaculum, then divides into the medial and lateral plantar (also termed calcaneal) nerves, where it is especially vulnerable. Pain from this source can mimic plantar heel pain. Tarsal tunnel syndrome is an entrapment of the posterior tibial nerve under the flexor retinaculum. Rarely, sural nerve symptoms can be related to Achilles tendinopathy, resulting in posterior heel neural signs.

• #2 Heel pain: a practical approach

  https://www.racgp.org.au/afp/2015/march/heel-pain-a-practical-approach

  The key tendons that may be involved in heel pain are the Achilles tendon at its insertion, flexor hallucis longus (FHL), tibialis posterior and the peroneal tendons. The medial and lateral tendons are surrounded by tenosynovial sheaths that can be irritated by friction or compression at the malleolus. Tibilais posterior pain (tendon and/or sheath) is most commonly seen in older women. FHL tenosynovitis is seen in younger people, especially dancers because of the repetitive movement of the ankle and foot between extremes of plantarflexion and dorsiflexion. […] The Achilles insertion is a complex structure that includes the retrocalcaneal bursa. All insertional pain should be treated holistically as a tendinopathy, as the bursa is rarely affected in isolation. The mid-substance and insertional Achilles tendon undergo similar histopathological change. Excess compression of the tendon against the superior calcaneus in dorsiflexion is the provocative load; however, a Haglund morphology (a square superior prominence of the calcaneus) is common and complete resolution of symptoms can occur despite the anatomy.

• #2 The Royal College of Podiatry

  https://rcpod.org.uk/common-foot-problems/heel-pain

  This is an inflammation of a bursa (a fluid-filled fibrous sac) under the heel bone where the pain is typically more in the centre of the heel than that experienced with plantar fasciitis and significantly worsens during the day. […] This condition can be caused by a fall from a height on to the heel. […] This can feel like a burning or tingling sensation under the heel within the arch of the foot with occasional loss of sensation on the bottom of the foot. […] This is caused by compression of the tibial nerve as it passes the inside of the ankle. […] This is caused by a heavy heel strike or sometimes a reduction in the thickness of the heel pad which can give rise to a dull ache in the heel which increases during the day. […] This painful condition affects young children, usually between the ages of 8 and 12, especially those who are physically active or undergoing a growth spurt.

• #2 Why does my heel hurt? 5 top causes | HealthPartners Blog

  https://www.healthpartners.com/blog/why-does-my-heel-hurt/

  Heel bursitis is another reason for pain in the back of your heel. […] Bursitis is inflammation of the bursa, which is a small sack of fluid that cushions and lubricates areas where the tissues rub against each other. […] If you fracture your heel for example, after a fall or jump from a great height or in a car accident youll probably know it by the sudden pain you feel in your heel. […] Long-term, repetitive straining of the ligaments that connect your heel to your toes can cause a bone spur to develop on your heel.

• #2 Sever’s Disease (Heel Pain) – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/severs-disease/

  Sever’s disease (also known as calcaneal apophysitis) is one of the most common causes of heel pain in growing children, especially children who are very physically active. It is an inflammation of the growth plate in the calcaneus (heel). […] Sever’s disease is caused by repetitive stress to the heel. It most often occurs during growth spurts, when bones, muscles, tendons, and other structures are changing rapidly. […] Repetitive stress from running, jumping, and other high-impact activities can cause pain and inflammation in this growth area of the heel. Additional stress from the pulling of the Achilles tendon at its attachment point can sometimes further irritate the area.

• #2 Children’s Heel Pain Common Causes, Symptoms and Treatment

  https://pediatricfootankle.com/foot-conditions/pediatric-heel-pain/

  Heel pain in children is not uncommon and can be caused by a few different issues. However, it is most likely due to Severs disease, Achilles tendinitis, a heel fracture, JIA, or Tendo-Achilles bursitis. […] The most common cause of childrens heel pain between these is Severs disease. This overuse injury occurs most often in athletic children ages 7 to 15, but may occur as young as 5. […] 90% of the heel pain cases we see and treat are due to Severs disease. The other 10% are due to other differentials. […] Active children, especially those engaged in sports, are more prone to heel pain due to a condition known as Severs Disease. This overuse injury, common in kids aged 7-15, results from the inflammation of the heels growth plate due to repeated stress from sports activities. […] Severs disease, also known as calcaneal apophysitis, stems from a rapid growth spurt associated with childhood. As the heel bone grows at an accelerated rate, the surrounding muscles and tendons become stretched and inflamed due to this sudden growth spurt that the child has not yet adapted to yet.

• #2 Pain in the Back of the Heel | Causes and Treatment

  https://sydneyheelpain.com.au/pain-in-the-back-of-the-heel/

  Haglunds deformity is a very common clinical condition that causes pain in the back of the heel of the patient. It occurs when an abnormal bony heel spur forms at the back of the heel bone, at the insertion point of the Achilles tendon. The soft tissues in the area then become irritated and inflamed when the bone spur rubs against tight fitting or rigid shoes. […] When the bursae in the posterior area of the calcaneus become inflamed or irritated, this is known as bursitis, and causes pain in the back of the heel. Retrocalcaneal bursitis is the inflammation of the bursa between the Achilles tendon and the heel bone. Retro Achilles bursitis is the inflammation of the bursa between the Achilles tendon and the skin. Retrocalcaneal bursitis usually occurs from constant irritation and pressure on the bursa, such as lots of uphill running, or in association with Haglunds deformity.

• #2 Foot problems – heel pain | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/foot-problems-heel-pain

  In many cases, plantar fasciitis is associated with heel spur. […] An abnormal walking style, such as rolling the feet inwards, can place extra strain on the plantar fascia. […] Chronic inflammation may develop and, over time, lead to a bony growth or spur. […] The spur itself does not cause the pain, but pain may be associated with inflammation in the area. […] Severs disease results from stress placed on the growth plate of the heel bone. […] An excessive amount of running or jumping causes inflammation to the growth plate, which results in pain.

• #2 Heel Spur Causes, Symptoms, Treatments, and Surgery

  https://www.webmd.com/pain-management/heel-spurs-pain-causes-symptoms-treatments

  Heel spurs occur when calcium deposits build up on the underside of the heel bone, a process that usually occurs over a period of many months. […] Heel spurs are often caused by strains on foot muscles and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. […] Heel spurs can cause heel pain. They are frequently associated with plantar fasciitis, a painful inflammation of the fibrous band of connective tissue (plantar fascia) that runs along the bottom of the foot and connects the heel bone to the ball of the foot. […] In general, the cause of the pain is not the heel spur itself but the soft-tissue injury associated with it. […] The heel pain associated with heel spurs and plantar fasciitis may not respond well to rest. […] In many cases, a functional orthotic device can correct the causes of heel and arch pain such as biomechanical imbalances. […] If conservative treatment fails to treat symptoms of heel spurs after a period of 9 to 12 months, surgery may be necessary to relieve pain and restore mobility.

• #2 Plantar Fasciitis

  https://www.foothealthfacts.org/Conditions/PlantarFasciitis

  Heel pain, especially stabbing heel pain, is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. […] Heel pain is often caused by plantar fasciitis. […] Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain. […] The most common cause of plantar fasciitis relates to faulty structure of the foot. […] Wearing nonsupportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. […] People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they have been sitting for long periods of time.

• #2 Heel Spurs: Treatment, Causes & Symptoms | The Feet People Podiatry

  https://www.thefeetpeople.com.au/symptoms-we-treat/heel-spurs/

  It is very common for our podiatrists to hear that when a person develops heel pain, they quickly suspect that their pain is caused by a heel spur. While heel spurs have become a common term to explain heel pain, this isnt technically accurate, and for over 95% of the patients we see with pain at the bottom of their heel, the true cause of pain is actually a condition called plantar fasciitis. […] Heel spurs have been shown to develop in response to damage and strain to the soft tissues that insert at the bottom of the heel – in this case, the insertional fibres of the plantar fascia tissue. When the plantar fascia, which connects to the bottom of the heel bone, repetitively pulls on and places stress on the heel during movement, this creates micro-trauma. The body responds by trying to repair the area by creating more bone – this becomes the calcified protrusions that we know as heel spurs.

• #2 Heel pain | www.trek-lite.com

  https://www.trek-lite.com/index.php?threads/heel-pain.12785/

  The reason for overpronating is not so often weak feet, but poor foot/knee alignment. When one has laterally rotated feet (duck feet), this exposes the knees (often causing medial / inner knee pain due to overextending MCL (inner knee ligaments) connective tissue. This in return makes the feet roll inward, rather than working like they should be, which is lateral displacement of calcaneus (heel bone moves to the side), which allows a controlled descent of the arch back. With duck feet, one is chronically in collapsed arch mode, thus overpronating. […] Arch supports prevent the arch from moving properly, and thus not fixing the root cause of the issue, but give artificial support. It’s like putting your foot in a cast to stop it moving. Then the immovable foot becomes weak and when the muscles are weak, the connective tissue starts to build up to give it support. Suddenly your in a situation where you have a weak stiff foot. Whereas trail runners let the foot move more than stiff soled boots, they do often have a fairly well cushioned thick midsole. This midsole wears out often sooner than the rest of the trail runner and when it wears out, it stops supporting the foot and starts to give in more. This unsupportive, worn out midsole in combination with the stiff weak foot starts to cause issues as now there’s more foot movement due to lack of support from the shoe and from the muscles. Since tissue supports passively, it can start to have micro tears due to being forced to stretch more than it’s capable when the external support is gone. These micro tears are then often diagnosed as plantar fasciitis.

• #2 Plantar fasciitis: Symptoms, causes, and treatments – Harvard Health

  https://www.health.harvard.edu/pain/plantar-fasciitis-symptoms-causes-and-treatments

  Plantar fasciitis occurs when the plantar fascia, a fibrous band of tissue on the bottom of the foot that helps to support the arch, is overloaded or overstretched. […] This constant stretching and strain of the plantar fascia can lead to chronic degeneration, or the development of small tears in the fascia fibers, particularly where the fascia connects to the heel bone. […] In addition to tears, ultrasound evaluations often show calcifications, and thickening of the plantar fascia.

• #2 Heel pain: Causes, prevention, and treatments

  https://www.medicalnewstoday.com/articles/181453

  Heel pain most commonly occurs under the foot, behind the heel, and on the inner or outer side of the heel. […] It may result from excessive pressure on the heel caused by running, standing for long periods, or carrying extra weight. Tight calf muscles or high arches may also contribute to heel pain.

• #2 Heel Pain: Causes, Treatments, and Prevention | Thomson Medical

  https://www.thomsonmedical.com/blog/orthopaedic/heel-pain

  If conservative treatments fail to provide relief, some patients may require surgery to remove bone spurs, release tight tendons, or repair damaged tissues. […] Chronic heel pain may be a sign of other, more serious medical problems. […] Plantar fasciitis is the most common cause of heel pain, especially among middle-aged individuals and those who are overweight, active, or spend a lot of time on their feet. […] Stretching exercises such as heel raises, calf stretches and plantar fascia massage that target the Achilles tendon, calf muscles, and plantar fascia are effective for relieving heel pain.

• #2 Plantar Fasciitis > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/plantar-fasciitis

  A splint worn at night will hold your foot at a 90-degree angle and allow the plantar fascia to stretch while you sleep. […] However, if simple treatments dont work and the pain is limiting your lifestyle, your doctor may recommend a cortisone shot to the plantar fascia, which reduces the pain. […] He notes that the root cause is often an extremely tight gastrocnemius (calf muscle). For those patients, a surgery to lengthen the gastrocnemius may be able to address the problem.

• #2 Heel Pain In The Morning: Help Plantar Fasciitis | Franciscan Health

  https://www.franciscanhealth.org/community/blog/heel-pain-in-the-morning–how-to-help-plantar-fasciitis

  Chronic overuse or repetitive tension on the plantar fascia causes pain at its origin on the plantar calcaneus (heel bone). […] Morning pain is from the sudden tension of the plantar fascia as it gets stretched after shortening overnight. […] Heel spurs do not cause the pain, rather they are a sign of long-standing tension on the plantar fascia. […] The most effective treatment for plantar fasciitis includes calf and Achilles stretching, plantar fascia stretching, and a night splint or a night sock, Dr. Narcisi said. […] Not treating plantar fasciitis may result in chronic heel pain that makes it harder to do your regular activities.

• #2 Plantar Fasciitis: Causes, Symptoms, Treatments, and More

  https://www.healthline.com/health/plantar-fasciitis

  Plantar fasciitis causes pain in the bottom of the heel. The plantar fascia is a thick, weblike ligament that connects the heel to the front of the foot. It acts as a shock absorber and supports the arch of the foot, helping you walk. […] The plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness. […] However, plantar fasciitis isn’t actually caused by heel spurs. It tends to develop due to the overstretching or overuse of this ligament, although a tear or small tears in the fascia tissue can also cause pain. […] Without proper treatment, plantar fasciitis can lead to rupture or damage to ligaments, loss of fat tissue in the foot, and decreased arch support. […] Note that rupture is particularly likely if you do steroid injections because this can weaken the ligament.

• #2 Heel Pain (including Plantar Fasciitis)

  https://patient.info/doctor/heel-pain

  Systemic arthritic diseases may present with heel pain. These include the seronegative arthritides, psoriatic arthritis, reactive arthritis, diffuse idiopathic skeletal hyperostosis (DISH), rheumatoid arthritis, fibromyalgia and gout. […] Acute trauma to the calcaneus is the most common bone cause of heel pain. This usually occurs following a fall from a height on to the heel. […] Stress fractures of the calcaneus occur as a consequence of repetitive load to the heel. […] The most common site of stress fracture is just posterior and inferior to the posterior facet of the subtalar joint.

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