“Heel Pain: Don’t Underestimate It”
Heel pain is a common symptom that can become chronic if not addressed properly. According to Silvia De Martinis, an orthopedist at the First Orthopedic Clinic Asst Gaetano Pini-CTO in Milan, the most frequent causes of heel pain are inflammatory pathologies affecting the insertion of the plantar fascia or the Achilles tendon to the heel. These conditions are often exacerbated by mechanical overload, repeated microtraumas, and foot support defects such as flat, hollow, or overpronated feet.
The pain from these conditions can vary in its location and timing. Plantar fasciitis pain is often felt in the most plantar part of the heel, especially after a period of rest, while Achilles tendinopathy pain occurs in the back part of the heel during physical activity. Over time, these conditions can become chronic, leading to the development of calcifications at the point of insertion of the plantar fascia or the Achilles tendon, as well as bursitis in the posterior part of the heel.
In the acute phase, treatment for heel pain typically involves ice packs, anti-inflammatories, and rest. However, if the pain persists, it is advisable to seek an orthopedic visit to determine the underlying cause. Additional investigations, such as x-rays and ultrasound, may be necessary to evaluate the extent of the condition.
The treatment for plantar fasciitis is often conservative, focusing on biomechanical correction with specific insoles, stretching exercises, and massage. Weight loss is also recommended for overweight individuals. Other therapies, such as focal shock waves and PRP therapy, can also be beneficial. Surgery for plantar fasciitis is rare, as conservative treatments are often effective in resolving the condition. On the other hand, Achilles tendinopathy may require scarification surgery to stimulate repair and prevent a rupture.
In conclusion, heel pain should not be underestimated, as it can become chronic if left untreated. Seeking early intervention and proper treatment can help alleviate symptoms and prevent long-term complications.