Heel Pain Syndrome and Plantar Fasciosis (Fasciitis)

It is often described as a "stone bruise" by the patient. Pain is usually worse in the morning, especially with the first several steps, or after periods of rest when first standing. As the pain worsens, the heel can hurt even while not weight-bearing.

What causes it?
Heel pain may be caused by many different factors ranging from simple mechanical plantar fasciitis (fasciosis) to complex metabolic diseases such as Reiter's syndrome. Most heel pain is related to the plantar fascia, but many times the patient is mistakenly diagnosed, or has additional masked pathology such as a nerve entrapment. Heel pain is believed to affect more than 2 million Americans each year, and accounts for more visits to a doctor than any other foot condition.


How is it diagnosed?

In order to assure a correct diagnosis of what is actually causing heel pain syndrome, it is necessary to implement several diagnostic modalities in order to make an accurate diagnosis, and assure the best treatment outcome for the patient. These studies will almost always include x-rays. Additional studies that may be ordered could include diagnostic musculoskeletal ultrasound (DUS), Neurosensory Testing with the Pressure Specified Sensory Device (PSSD), and MRI's. With the ability to accurately stage and grade the degree of plantar fasciitis (fasciosis), a customized treatment protocol will be selected for each individual patient. This type of diagnostic work-up and assessment has been pioneered by Dr. Barrett, and is not widely available at this time. What this means for the patient is that they will no longer be categorized as just having plantar fasciitis, and subjected to long periods of failed conservative care. By knowing the actual degree of degeneration in the tissue of the plantar fascia, a better and faster treatment regimen can be instituted. Most cases of plantar fasciitis (fasciosis) can be treated successfully with non-surgical intervention.