If the back of your foot aches, you are not alone. The most common cause of heel pain is a condition called plantar fasciitis, which causes a pain that begins under the heel and radiates into the arch.Plantar fasciitis involves an irritation of the plantar fascia, a band of connective tissue that runs from the heel along the bottom of the foot, supporting the arch.

In most cases, plantar fasciitis does not result from an injury. Wearing nonsupportive footwear on hard, flat surfaces, especially in a job that requires long hours on the feet, puts abnormal strain on the plantar fascia and can lead to plantar fasciitis. Obesity may also contribute to the condition.

The good news is that over 90% of patients don’t require surgery and improve after one year of conservative treatment.  The first line of treatment for plantar fasciitis pain is a set of specific but simple stretches, one for the foot and one for the calf. Diligently performing these stretches will often, although not always, reduce and eventually eliminate the pain.  Other strategies such as consistently wearing footwear that provides arch support can help this condition improve over time.

However, if you have been stretching regularly with little or no result, we can take the treatment several steps further. A 2011 study published in the Journal of Orthopaedic and Sports Physical Therapy offers good evidence that hands-on physical therapy, in addition to regular stretching, works better than stretching alone to relieve chronic heel pain. Such therapy focuses on manipulating knotty “trigger” points in the calf muscles. Individuals who received this treatment reported experiencing less pain.  A nice adjunct to foot and ankle stretches is wearing a night splint that stretches you as you sleep.

Orthotics placed in footwear can help “unload,” or rest, the plantar fascia. Self-massage techniques and applying ice and/or moist heat may also encourage healing. Once healing takes place, your physical therapist can teach you how to use your hips, knees and feet in tandem when you walk to minimize plantar fasciitis.

Other modalities to reduce heel pain include therapeutic ultrasound and electrical stimulation. Education is also important to be sure you understand what kind of movements to avoid to help reduce the likelihood of heel pain recurrence.

And all of this can improve your general mood, too — no one feels good when their feet hurt. With our professional guidance, you can alleviate that annoying heel pain and prevent it from coming back.