As you may have realised, we are involved with a 3-week national campaign to increase awareness of the Podiatrist’s role in the assessment, diagnosis and treatment of heel pain and plantar fasciitis. Last week, I had a patient in my clinic that thought she had plantar fasciitis and I thought I would share the story…
Mrs Jones is a routine podiatry patient. She comes regularly for nail care and removal of corns and hard skin. She usually sees one of the other podiatrists, but last week she was accidentally booked into my clinic. Because of the error, she was a little disgruntled, so I was being extra thorough with my treatment. When I asked about any foot pain or problems, she mentioned that her heel had been hurting for a few months, she hadn’t mentioned it to the usual Podiatrist as she didn’t know that we knew about things like this. She had been advised by the Doctor that it was plantar fasciitis and that she should use ice and do calf stretches, which she had been doing for 6 weeks with a small improvement. I was intrigued, so I asked her where, specifically, in her heel that the pain was. When she pointed to the inside of her ankle, I realised that this could not be plantar fasciitis, as the plantar fascia is in the sole of the foot.
I assessed Mrs Jones in a standing position. I could see that she had a very mobile foot type that was inclined to being unstable. As I watched her rise onto tip-toes I could see how difficult this was in terms of balance and in terms of muscle strength. Her “heel” pain was actually an inflamed tendon on the inside of her ankle which was caused by a collapsing and unstable foot type.
I recommended that she carried on with ice to relieve the inflammation. But also booked her an appointment with our MSk (musculo-skeletal) Podiatrist for assessment for orthotics (supportive insoles) which I think will improve her symptoms quickly. Thankfully, she was thrilled that I was able to explain the root of her problems and was looking forward to a good improvement.
The most common cause of heel pain is plantar fasciitis but there are over 40 different causes of pain in that area. First line treatments such as ice, stretching and footwear changes are a great start, but getting appropriate assessment and diagnosis is key to improvement long-term.
If you are suffering and you’d like to read more about first line treatment and next steps (pardon the pun) have a look here www.thefootroom.co.uk/heelpain
The Foot Room, providing a full range of Podiatry and Chiropody treatments including Swift verruca treatment, spa pedicures, reflexology, ingrowing toenails, fungal nail treatments, cracked heels, corns and orthotics to the people of Longridge, Broughton, Preston, Fulwood, Clitheroe, Whalley, Blackburn and Garstang.