Heel pain is a common condition in which there is extreme pain or discomfort in the heel on weight bearing. It settles down quickly if treated early and given enough rest but may become worse and chronic if initial symptoms are ignored.
The plantar fascia is a thick and tough band of fibrous tissue, running along the base of the foot from the heel to the base of each toe. It stabilizes the many small joints between the foot bones and acts as shock absorber during weight-bearing activities like standing and walking to high impact activities like jumping, sprinting, etc.

Causes of Heel Pain
Can be either plantar fasciitis or heel spur syndrome.
Plantar Fasciitis
As a person gets older, the fascia becomes less elastic. The heel pad becomes thinner and looses the capacity to absorb as much shock. There may be some swelling, small tears or bruises in the plantar fascia with the pounding force on the heel. The younger people who are more active in sports, may suffer from heel pain too.
Risk factors for plantar fascitis include:

Being obese / overweight

Diabetes

Prolonged standing or walking

Increasing activity over a very short period of time

Injury

Being flat-footed or having a high arch

Wrong / Improperly fitting footwear

Wearing high heels for much of the time will cause tight calf muscles and plantar fascia due to the foot positioning

Heel pain sometimes results from excessive in turning / flat foot which puts additional stress on the fascia and may ultimately lead to plantar fasciitis.

Heel Spurs
A heel spur is a bony growth on the underside of the heel bone, where the fascia attaches. It develops as a result of excessive and repetitive pulling of plantar fascia on the heel bone. The heel spur may press into the sensitive nerves and soft tissue, resulting in pain in the foot. A heel spur can develop along with plantar fasciitis, but may also occur by itself.
Heel spurs can be seen as hook shaped protrusions in X-rays.
Heel spurs are commonly seen in:

Middle-aged patients

Athletes are especially prone to heel spur due to the repetitive stress on their heels

Abnormal walking pattern or pronation i.e. in turning of the foot or when the foot regularly hits the ground in unusual ways, damage can occur since tissue becomes stretched or stress excessively, leading to formation of a heel spur.

Symptoms of Heel Pain

Burning, stabbing, or aching pain in the heel or along the arch of the foot.

Most people would feel it first thing in the morning because the fascia ligament tightens up during the night sleep.

Resting provides only temporary relief.

Physiotherapy Treatment
In most cases, plantar fasciitis/ heel spur does not require surgery or invasive procedures to stop pain and reverse damage. Conservative treatments are usually all that is required. However, every person's body responds to heel pain treatment differently and recovery times may vary.
Physiotherapists are able to determine the cause and type of your heel pain and treat it accordingly. Treatment commences initially with pain alleviation and gradually incorporates lower limb strengthening program.

Radial Shockwave therapy: Shock wave therapy is a new form of non-invasive treatment which works by initiating a healing response by the body by causing blood vessel formation and increased delivery of nutrients to the affected area

Interferential therapy: Electrical current that stimulates the peripheral sensory and muscle nerve fibers to reduce pain and inflammation.

Ultrasound: The application of ultrasonic waves causing improved cell metabolism and cell membrane permeability, thereby enhancing tissue healing

Mobilization & manual therapy: Significant effect to restore any restricted mobility between the foot bones or muscle. This aids to reduce pain and stiffness.

Laser: This low-level laser therapy absorbed by the photo-sensitive body tissue, aids in pain management and helps with wound healing.

Foot Taping: Taping or strapping supports the foot, placing stressed muscles and ligaments in a restful state.

Stretches/ Strengthening Exercises: Stretching the tight muscles/ fascia as well as some leg/ankle strengthening exercises can help to reduce the strain on the fascia

Although heel pain may generate only slight discomfort, they can worsen and generate severe pain over time. In most cases, luckily, treatment only needs to be through conservative methods. Often, heel pain sufferers try to ignore initial pain and other signs of damage. But ignoring the problem only makes it worse, and it's important to seek help and treatment as soon as possible to prevent further damage.

Tips for Prevention

Visit a physiotherapist and have it treated early.

Wear the proper shoes for each activity.

Do not wear shoes with excessive wear on heels or soles.

Prepare properly before exercising.

Pace yourself when you participate in athletic activities.

If obese, lose weight.

Experienced physiotherapists in Singapore, with over 18 years of experience, help you to get relief from pain/weakness quickly and easily. You can book an appointment to see our Senior Physiotherapist. We are located right in the heart of Singapore, at Orchard, and are available Mondays through Saturday.