Inflammation in heel pain
Plantar fasciitis is classically described as pain in the heel with the first few steps in the morning or after periods of sitting that gets better with walking. When you’re sleeping or not on your feet, the fibrous band that connects the bottom of your heel and extends to your toes are in a relaxed state. Think of this as a rubber band that is sitting on the table in it’s relaxed state. As soon as you step down, the plantar fascia is stretched out and can provoke pain if stretched too quickly. Much like a rubber band that suddenly gets stretched beyond it’s flexibility, it can snap. Although the plantar fascia rarely snaps when you go into a stepping position, it can feel just as painful.
Diagnosing this condition starts with the clinical picture of when pain is first noticed, what makes it worse, and what makes it better. From here, additional tests may be done such as xrays, ultrasound and/or MRI to rule out other disorders including fat pad atrophy, nerve impingement, bone marrow edema, tumor, fascia tear and so on.
Conventional treatment includes stretching and strengthening exercises that focus on the plantar fascia, Achilles tendon and higher. Some may benefit from steroid injections, although this is slowly falling out of favor and is being replaced with more regenerative options. Surgery may be a consideration as well when all else fails.
Sometimes a unicorn presents itself where the symptoms don’t perfectly align or the traditional treatments aren’t giving enough relief. That’s where a skilled foot and ankle specialist who specializes in functional podiatric medicine can help.
Functional podiatric medicine looks at two specific things that makes us uniquely different and an expert in foot pain. We dig our heels deeper (pun intended) into finding the root cause of pain by looking at:
the biomechanics or body structure relationship of your feet and higher up and/or
the hormone imbalances that may be triggering you to experience more inflammation than is normal
After all, you are connected to your feet so a holistic approach to treating foot pain may also include addressing aggravating stressors. Not just the physical stressors of poorly fitted shoes or overactivity, but also the physiological influence on the immune system that is controlled by a variety of hormones in our body. When our body is stressed or is in pain, we look at what may be dampening our ability to heal and recover.
We all have a different threshold at which our bodies will reveal symptoms and a poorly functioning immune system also affect how we experience physical pain on a cellular level.
If you find that your heel pain isn’t getting the resolution you’re looking for with conventional care, it may be time to dig deeper to find out what is stalling your healing progress to optimize your outcome.
