Dealing with foot pain, specifically heel pain can really throw a monkey wrench in your life and daily activity. The two most common causes of heel pain are plantar fasciitis and tarsal tunnel syndrome. But despite this, they have different causes, symptoms, and treatments.
Plantar fasciitis and tarsal tunnel syndrome are two very different causes of heel pain. While plantar fasciitis affects the plantar fascia, tarsal tunnel syndrome involves extra pressure on the tibial nerve.
Table of Contents:
I. Plantar Fasciitis
Plantar fasciitis refers to the inflammation of the plantar fascia, a thick band of tissue that connects the heel bone to the ball of your foot. Common causes for plantar fasciitis include overuse, too much stress on the feet, or strain of the plantar fascia. Athletes, individuals who are overweight, or gain weight in a short amount of time (ex: during pregnancy), and people that don't wear the right shoes for their foot type have more of a risk of developing plantar fasciitis. To go more in-depth on the causes of plantar fasciitis, click here for a blog post from me here: https://www.directpodiatryaz.com/post/12-plantar-fasciitis-causes
Some symptoms of plantar fasciitis are:
Pain in the heel or arch of the foot, usually at its worst first thing in the morning
Heel pain that increases after long periods of being inactive.
Heel pain that increases after a long time standing or physical activity.
A diagnosis of plantar fasciitis is usually made through an exam and by going over your medical history. Tests like X-rays, MRI, or ultrasound can also be ordered make sure there arent other possible causes of your heel pain.
Some treatment options for plantar fasciitis are:
1. Resting and changing your activity temporarily:
Avoiding certain activities temporarily that increase your heel pain can help get rid of plantar fasciitis.
2. Physical therapy:
A physical therapist can prescribe additional stretches and exercises to increase your flexibility and help with plantar fasciitis pain.
3. Shoe inserts or orthotics:
Using shoe inserts, insoles, or orthotics can help by placing your foot in proper alignment, which then can remove extra strain on your plantar fascia.
Orthotics can also come with added features to pad your heel, also helping to overcome plantar fasciitis.
4. Night splint:
A night splint gently stretches the plantar fascia as well as the Achilles tendon while you are sleeping, which over time increases your flexibility and can help get rid of plantar fasciitis pain.
Anti-inflammatory drugs like NSAIDS can be used to lower pain and inflammation from plantar fasciitis temporarily.
6. Cortisone injections:
In severe cases, cortisone injections can help quickly treat the pain from plantar fasciitis.
This is also temporary.
To learn more about cortisone shots for plantar fasciitis, click the link for my blog post on this topic: https://www.directpodiatryaz.com/post/cortisone-shot-for-plantar-fasciitis
7. Platelet Rich Plasma (PRP):
PRP takes stem cells from your own blood, and injects them into your plantar fascia to help stimulate healing.
8. Extracorporeal Shockwave Therapy (ESWT):
ESWT is a non-surgical treatment option for plantar fasciitis uses sound waves to stimulate healing, and help get rid of heel pain.
To learn more about conservative treatment options for plantar fasciitis that can be done at home, click here for my blog post: https://www.directpodiatryaz.com/post/at-home-treatments-for-plantar-fasciitis
II. Tarsal Tunnel Syndrome
Tarsal tunnel syndrome happens when a nerve in your foot, called tibial nerve, becomes squeezed or has extra pressure placed on it. The tibial nerve runs through a narrow tunnel on the inside of the ankle., called the tarsal tunnel. Factors like having flat feet, previous ankle injuries, or even diabetes, can increase your risk of developing tarsal tunnel syndrome. A cyst or tumor inside of the tarsal tunnel can also cause tarsal tunnel syndrome.
Some symptoms of tarsal tunnel syndrome are:
Numbness, tingling, shooting pain, or burning in the heel, arch of the foot, or ankle.
Pain that travels from the ankle, down into the sole of the foot.
Heel pain that gets worse with standing or walking.
Becomes harder to flex your toes over time
A diagnosis of tarsal tunnel syndrome involves discussing your symptoms with your foot doctor. Your foot doctor then will take your medical history, and do an exam. Nerve conduction tests or electromyography (EMG) can be ordered to be sure that your diagnosis of tarsal tunnel syndrome is actually correct. EMG is also used to see how severe the nerve compression is.
Some treatment options for tarsal tunnel syndrome are:
1. Rest and immobilization:
Take a break from activities that make your symptoms worse.
Using orthotics or braces to support or limit certain motions in the foot can remove pressure from the nerve and help alleviate symptoms of tarsal tunnel syndrome.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can also be taken to treat the pain and inflammation from tarsal tunnel syndrome temporarily.
3. Physical therapy:
Stretching and strengthening exercises, prescribed by a physical therapist can increase flexibility in your feet, and help in healing.
4. Cortisone injections:
Cortisone shots can also be used in tarsal tunnel syndrome to treat your symptoms temporarily.
In severe cases, when conservative treatments fail, surgery can be considered to release the pressure on the tibial nerve.
Understanding the differences between these conditions is very important for you to receive a correct diagnosis and treatment. Hopefully, now that we have reached of this article, you are better informed on both conditions and be better able to seek appropriate care for your heel pain.
Are you dealing with heel pain live in the Phoenix area? My name is Dr. Tarr. I am a board-certified foot doctor, and the owner of Direct Podiatry Arizona in Tempe, AZ. To view available appointment times, click here: directpodaz.janeapp.com