Heel pain is one of the most common but painful problems seen in a podiatrist's office. It is usually due to excessive pulling on a major supportive ligament in the heel called the plantar fascia.

The symptoms are most often described as pain and stiffness in the heel with the first step in the morning. The pain may improve after a few minutes but usually returns as the day progresses or after sitting for an extended period of time. The condition is known as plantar fasciitis, but is also referred to as heel spur syndrome, stone bruise or heel bruise.

As we age, the plantar fascia can loose its elasticity. It can start to pull at the heel and cause inflammation around the nerve and bursa (a fluid filled sac). The pain comes from the irritable nerve and bursa by the Plantar Fascia strain. Over time a heel spur may develop due to constant tugging of the Plantar Fascia on the heel bone.

	Taping
	Custom orthotics / arch supports
	Medications
	Stretching
	Cortisone injections
	Icing

When non-surgical therapies do not provide satisfactory relief from pain, surgery is most often recommended. The latest surgical technique to relieve chronic heel pain is the In-Step Plantar Fasciotomy and has many advantages:

	Early return to normal activities.
	Decreased postoperative pain. (Most patients have only modest discomfort for the first few days following surgery.)
	Done in outpatient surgery
	Small incision