Plantar Fasciitis: Healing Heel Pain
Posted 5/24/2016 by UHBlog
Heel pain is often diagnosed as plantar fasciitis. However, this is actually a misnomer, according to family medicine specialist Robert Truax, DO.
“Fasciitis implies that there is inflammation of the plantar fascia, the tough connective tissue running from the heel to the toe that helps create the arch of your foot,” Dr. Truax says. “Primary fascial pain (PFP) is a better way to describe the condition.”
There are three ways that heel pain can result from inflammation. They include:
- Autoimmune disorders, such as diabetes
“I don’t deny that inflammation can be a reason for heel pain, but it is greatly overrated as a reason for this kind of pain,” he says. “If someone tells me they ran a half marathon yesterday and have heel pain today, that may very well be inflammation from trauma associated with running that far. Most people, though, come to me talking about how their foot has been bothering them for weeks with no known reason.”
To determine the cause of your heel pain, Dr. Truax looks for anatomical abnormalities, such as extremely flat feet and leg length differences. Or, the cause could be due to a disorder or disease, including:
- Metabolic disorders
- Rheumatic disease, such as damage from rheumatoid arthritis
- Degenerative diseases, including osteoporosis
“For PFP, the evaluation and treatment both begin with the hips,” he says. “I evaluate the lower back and pelvic areas because the foot lands where the hips tell it to. If there is tightness or restriction in the hips, the foot lands incorrectly, setting up abnormal stress loads that can result in pain.”
He also assesses other muscles around the ankle and/or foot. If any of these are weak, that can be an indication that your body is trying to compensate for changes in stress loading. If your hips aren't working well and if you have weak muscles around your feet, that's a recipe for heel pain, he says.
As an osteopathic physician, Dr. Truax believes that when a malfunctioning body part is located, gentle manipulation in the area allows the body to heal itself naturally. Osteopaths do prescribe drugs or suggest surgery when those treatments are needed. However, they also have additional hours of training that focus on the structural mechanisms of the body, and how to use their hands to manipulate and heal the body.
“Traditional medicine typically focuses on disease or a specific pain, but DOs look for the source of a problem using a patient-centered, hands-on, holistic approach to diagnosing and treating illness and injury,” he says. “When a patient complains of heel pain, for example, I look for an imbalance somewhere else in the body to see where else that pain might be coming from."
Most of the time, your pain is an indicator of problems elsewhere, and the heel is just the victim, Dr. Truax says.
“Osteopathic medicine understands the intimate and interrelated role of the biomechanics throughout the whole body,” he says. “We find out where a person is out of biomechanical balance and then use our hands to gently pull, push or massage to make sure the many joints in your body are properly aligned so movement is easier, efficient and pain free.”
Robert Truax, DO is a family medicine specialist with University Hospitals Connor Integrative Health Network who focuses on sports-related injuries and rehabilitation. You can request an appointment with any UH Connor Integrative Health Network provider online.