| Heel Pain / Plantar Fasciitis |
Plantar fasciitis, the most common cause of heel pain, may have several different clinical presentations. Typically it presents with pain under the heel, worse in the morning and worse after a period of sitting down.Although pain may occur along the entire course of the plantar fascia, it is usually limited to the inferior medial aspect of the calcaneus, at the medial process of the calcaneal tubercle. Plantar fasciitis occurs in both men and women, but is more common in the latter. Its incidence and severity correlate strongly with obesity.
Diagnosis
The diagnosis of plantar fasciitis is based mainly on the medical history and clinical presentation. Muscusloskeletel ultrasound however offers a highly accurate method of assessing the thickness of the plantar fascia which directly correlates to pain. If the plantar fascia on ultrasound imaging is > 7 mm and also appears to be dark or contain low reflective areas then the diagnosis can be confirmed. Ultrasound can also rule out erosions of the calcaneus which if present would suggest a diagnosis of inflammatory arthritis e.g. Rheumatoid.
Treatment
1. Stretching exercises for the foot and calf.
2. Sometimes a soft heel pad is used
3. Strengthening the intrinsic muscles of the foot is important, looking at the biomechanics of your foot is also important.
4. An ultrasound guided injection into the under surface of the plantar fascia. This is the most accurate method of injection provides lasting relief.
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