Plantar fasciitis is pain directly at the base of the heel and is often referred to as heel spur syndrome. This should be diagnosed correctly as there are a multitude of surrounding structures and conditions which can cause pain at the heel.
Plantar fasciitis is related to plantar fasciopathy or plantar fasciosis; these are specific terms to categorize plantar heel pain.
Neglecting heel pain or masking it with painkillers is not advisable; we highly recommend you see a specialist if you experience heel pain. The longer heel pain is neglected, the more damage it accumulates. Plantar fasciitis is a degeneration of the plantar fascia; this is the strut to hold up your foot arch. If this continues to degenerate the connective tissue can tear or rupture, requiring cast immobilization or possible surgical intervention.
Lastly, heel pain may be another condition mimicking plantar fasciitis which would require a different treatment from our podiatrists: such as fat pad syndrome, calcaneal bone cyst, nerve impingement or referred pain from the ankle.
Shockwave therapy is a non-invasive method that uses pressure waves to treat various musculoskeletal conditions. A high-energy (acoustic) wave is focused on the area of concern. The shockwaves deliver a mechanical force on the body’s tissues that induce self-healing. When used as part of a tailored treatment plan, patients can be pain free after the first session.
This treatment modality is highly operator dependent and lower limb specialists are the ideal health professionals to seek for foot and ankle issues. We employ the use of shockwave technology to obtain optimal results for heel pain recovery in the shortest amount of time.
Ultrasound therapy is a non-invasive method that deposits high energy into tissue; this induces various biological effects, which stimulates the underlying tissue to heal. Targeted non-steroidal anti-inflammatory drugs are commonly used to supplement the effect of the ultrasound healing. Patients can often see immediately reduced swelling and reduced pain in the areas of concern after 1 session of ultrasound.
You are advised to see a Podiatrist soon if you are experiencing any pain on the heel, waiting for the pain to simply go away could further aggravate the condition. Early intervention is key to fast and effective recovery.
Bring along your most common foot wears when seeing your Podiatrist.
Author: Podiatrist Georgina Callaghan-Tay
Photo with courtesy of patient, we congratulate the lovely couple Mr & Mrs Gill on the birth of their beautiful child 🙂
“When my husband and I found out we were pregnant, like most new parents, we were overjoyed. We didn’t think it was a possibility for us as we were both in our late thirties. As new parents-to-be, we went about making sure we gave our little pea the best start. I ate healthy, exercised regularly, gulped my pre-natal vitamins down like a good girl. I did all the right things essentially. What didn’t cross my mind to even consider were my feet. However, they became such a debilitating and painful problem post-birth that I wish I knew about the condition sooner and could have perhaps taken some preventative action.
I have always had neck/shoulder and low back pain (from pre-existing
herniated discs). I was quite worried during my pregnancy that my back would flare up especially as it progressed. However, my back pain was manageable during my pregnancy and I felt great. Unexpectedly, two months post-birth, I started experiencing heel pain. It started with feeling pin-pricks whenever I first got out of bed in the morning and progressed quickly to feeling like I was walking on glass every time I got up from a resting position. This made getting up and feeding my little one every 2-3 hours such a nightmare.
As the pain became progressively worse, I did what any rational thinking adult would do in this situation. I asked “Dr. Google”.
It seemed likely that I had Plantar Fasciitis. Since my mum had it before, she ran me through some exercises that had helped her. I started doing those exercises to stretch my calf and area around my heel. It didn’t help. By this point, walking barefoot and wearing thongs when out and about (which had been my go to footwear throughout my pregnancy) were out of the question. I was in excruciating pain. I could not walk fast or very far at all. I hobbled along wherever I went. Lovely old ladies periodically overtook me. From easily walking 5km pre-pregnancy, I could now only walk less than a kilometre. I bought shoes with a higher arch and arch support insoles but they didn’t work either.
By this point, I was about six months post-partum. Between the lack of sleep and the pain, I was really struggling emotionally. I was not in a good place to see the joy of motherhood or enjoy my time with my baby. The pain was also affecting my ability to care for my bubba on a daily basis. I could not baby-wear him or take him for walks. I was exhausted and my entire body would ache from the sheer effort of looking after myself and bubba.
One Sunday afternoon, I hit my lowest point. I was in pain even at rest by this stage and in tears. My husband insisted I went to see someone. I was not thinking straight anymore but knew I needed professional help. We went back to “Dr. Google” for more answers. We came across the website for East Coast Podiatry Centre and read that they treated Plantar Fasciitis. When I called them and explained my situation, they asked me to come in immediately.
As I hobbled into the clinic, I did not know what to expect, having never seen a podiatrist or really knowing what they did. I was seen by Dr Michael Lai and Georgina Callaghan. They did a thorough assessment of my feet and did indeed diagnose my condition as Plantar Fasciitis. Dr Lai proceeded to perform an ultrasound treatment on my feet and I was measured for customised insoles. I was sent home with instructions on the type of shoes I needed to purchase and wear from here on out, even at home.
The next day, I noticed an immediate improvement. The pain had reduced by 80%. I was thrilled and relieved. I did not expect such a huge improvement that quickly. I was fitted with the customised insoles within two weeks and by this point was also wearing shoes with good arch support. The shoes and insoles really helped in providing the support and cushioning my healing feet needed. A routine of heat and ice each night was also set up by Georgina which helped to alleviate the aches and pains of the day.
Subsequently, I had two more rounds of ultrasound treatment. Unfortunately, that last 20% of pain did not reduce. We tried a round of shockwave treatment which was more intense. I had two pain free days after but it creeped back in soon after. Georgina and I discussed trying some calf stretching exercises but we could not shift that last 10-15% pain. Once we had exhausted all possible treatment options, Georgina sought opinion from other medical professionals. I was referred to a physiotherapist who suspected that my low back pain was causing the residual heel pain. Upon an assessment by the physiotherapist, it was discovered that the remaining heel pain was being triggered by nerve pain radiating from my lower back. I am currently under her care and the pain has lessened to a minimal amount.
As a result of the treatments, I feel like I am slowly getting my life back. I am walking much more, my pace has increased (now I am the one overtaking others). I am able to care for my bubba and feel so much more present in his life. I am more connected with my husband as well. I am now hopeful that my body will recover and the pain will go away – something I could not imagine before. Since having gone through this experience, I have discovered that Plantar Fasciitis is quite common in pregnancy and post-partum. The increasing weight during pregnancy and carrying your baby all day post-birth means that a lot of stress is placed on feet. If I had known about this earlier, I would have invested in better supportive shoes rather than wearing thongs, especially with my risk factors of having flat feet and back pain. I lived with the pain for so long before I sought treatment. I wonder if I had accessed treatment earlier, would issues have been less complex and easier to treat.
In writing this, I hope to highlight the potential issues that could arise during pregnancy and post-partum. Plantar fasciitis is treatable and no one should have to live with that kind of pain. For me, the existing low back issues complicated the Plantar Fasciitis and I am so grateful to Georgina for not giving up on me and working with other medical professionals to get me the best treatment. I am very thankful for her care and support through this entire process. And I am so happy to get my feet back on track!”
– Mrs. Gill