Heel pain is most commonly caused by a rolling inwards of the foot (excess pronation) when the foot is weight bearing. As weight comes onto the foot the arch collapses. The muscles and supporting structures are forced to stretch and elongate. This puts unnatural strain on the ligaments (fascia) running from the heel to the toes.
In this condition the main sites of the pain can be along the inner surface of the sole of the foot and, more commonly, in the centre of the heel where it strikes the ground. This centre heel pain is caused by hundreds of microscopic tears in the fascia where it attaches to the heel bone.
Pain is felt on intial weight bearing in the morning or after a period of rest. Prolonged exercise / walking gives rise to continuous pain and may become extremely crippling.
Whilst Plantar Fasciitis is a particularly unpleasant condition it does normally respond well to the correct treatment. This involves a period of strapping plus being fitted with custom built orthotic insoles to realign the foot. Thus the stretch forces on the fascia are reduced, so removing this common cause of heel pain. At the onset of treatment normal anti-inflammatory procedures, ice packs and anti-inflammatory drugs, are helpful to speed the process of recovery.
Cortisone injections can be helpful but they are a treatment of symptoms rather than the cause of the problem.
Heel spurs are often blamed as the cause of heel pain, but are normally coincidental. Almost all heel pain responds postively to correct orthotic therapy..