Foot, ankle, and heel pain may be caused by one of the following common foot conditions.
Plantar Fasciitis
Plantar fasciitis is an inflammatory response that is caused by degenerative irritation at the insertion of the plantar fascia ligament—which is a thick band of tissue that attaches your heel bone to your toes.
How is Plantar Fasciitis Diagnosed?
Your podiatrist will perform a physical exam to check for pain and/or tenderness in your foot. He or she will locate the exact location of your pain in order to rule out other foot conditions. Next, your podiatrist may ask you to perform various stretches to test the strength and health of the plantar fascia ligaments.
If the physical exam is not enough to diagnose the cause of your heel pain, your doctor may order x-rays of your foot to verify there is no stress fracture or other issue causing the pain.
Plantar Fasciitis Treatment
Initial treatment for plantar fasciitis usually involves conservative approach such as rest, ice, and avoidance of certain exercises. Other conservative treatment methods include:
- Orthotics/padding: Custom orthotics or heel pads may be used to cushion the foot and prevent pain.
- Stretches: Various stretches can be performed to elongate the plantar fascia ligament and relieve pain.
- Night splint: Your doctor may recommend a night splint to hold your foot at a specific angle to prevent ligaments from contracting during sleep.
- Injections: Anti-inflammatory steroid injections may be used to relieve inflammation and prevent pain.
More sever cases of plantar fasciitis might require surgery. The most common surgical procedure is known as a plantar fascia release, where the surgeon releases a portion of the plantar fascia ligament from the heel bone to relieve tension and pain. Surgery is often seen as a last result after conservative approaches have failed.
Tendonitis
Tendonitis is a very common cause of foot or ankle pain—it usually occurs due to inflammation around a tendon. This condition most often is the result of an overuse injury, but improper stretching or incorrect form during physical activity can also contribute.
Symptoms of Tendonitis
Pain associated with tendonitis is typically dull and aching, but as the condition worsens, you may experience sharp, burning, or radiating pain around the foot or ankle. Other symptoms of tendonitis include stiffness, swelling, weakness, or tenderness.
Diagnosis and Treatment of Tendonitis
Because tendon injuries typically worsen without proper treatment, immediate medical care is usually recommended. To diagnose your condition, your doctor will perform a physical examination and gather your medical history. During the physical examination, your doctor will look for instability, swelling, and weakness.
The goal of medical tendonitis treatment is to alleviate pain, and inflammation. The treatment method your doctor recommends will depend on the severity of the condition. For mild tendonitis, your doctor will most likely start with conservative treatments. These might include new shoe recommendations, arch supports or orthotics and prescription braces. For more serious cases of tendonitis, he or she may offer anti-inflammatory or cortisone injections to reduce any immediate pain. When the condition does not respond to noninvasive treatments, minimally invasive surgical procedures may be required.
Heel Spurs
A heel spur is calcium deposit located underneath the heel that causes small pieces of bone to protrude. Pain associated with heel spurs is often confused with another condition called plantar fasciitis—which refers to inflammation in plantar fascia ligament. A heel spur, on the other hand, is a piece of bone that forms on the heel bone itself.
Heel Spur Causes
Heel spurs take months to develop and may go completely unnoticed. Heel spurs are most often a result of too much stress or pressure on the ligaments in the foot. They can also be the result of repeated tearing of the membrane that covers the heel bone. The same physical activities that cause plantar fasciitis can result in heel spurs.
Treatment Options
Heel spurs cannot be diagnosed through a physical exam; they can only be seen using an x-ray. In fact, many heel spurs are diagnosed based off images your doctor takes while looking for something else. When heel pain persists for more than a month, you should contact your podiatrist. Your podiatrist may also recommend non-invasive treatment methods such as stretches, shoe replacements, custom orthotics, or physical therapy. Anti-inflammatory medications or injections may also be recommended.
Stress Fractures
Stress fractures are tiny cracks that appear in your bones. These injuries are common in the bones in the lower body because these bones are responsible for distributing and bearing your bodyweight.
Stress fractures are usually the result of an overuse injury and are most commonly experienced in runners and other athletes. Stress fractures occur over time due repetitive forces that occur on weight-bearing bones and supporting muscles. This constant repetition eventually causes small cracks to form in the bone.
While repetition and overuse are the most common causes of stress fractures, there are other factors that contribute to their development. Some of these causes include biomechanical problems, inflexible or weak muscles, training on the wrong surface, wearing improper or ill-fitting footwear, or a family history of osteoporosis.
Diagnosis & Treatment of Stress Fractures
To diagnose a stress fracture, your podiatrist will discuss your medical history and gather information about your symptoms. Then, he or she will perform a physical examination where they will check for areas of tenderness and pain. Once located, your podiatrist may recommend imaging tests—like x-rays or an ultrasound—to help confirm the diagnosis.
The treatment depends on the severity of your stress fracture. For mild stress fractures, your doctor will probably recommend non-surgical treatment. Some of these treatments include:
- Activity modification
- Protective footwear
- Better-fitting footwear
- Casting
- Padding
- Custom orthotics
When a stress fracture does not respond to the above methods, surgery may be recommended. Surgery usually involves inserting some type of fastener—like pins, screws, and/or plates—to support the bones in the foot or shin.