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Heel Pain

Heel Pain

Heel pain is an extremely common complaint, and there are several common causes. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the cause.

 

If you have heel pain, some causes include:

 

Plantar Fasciitis

Plantar fasciitis is the most common condition that causes heel pain. Plantar fasciitis is due to irritation and inflammation of the tight tissue that forms the arch of the foot. Common symptoms of plantar fasciitis include heel pain with prolonged walking and standing.

 

Heel Spur

A spur is commonly associated with plantar fasciitis. This problem is most commonly seen in patients who have long standing heel pain due to plantar fasciitis.

 

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome causes a large nerve in the back of the foot to become entrapped, or pinched. Similar to carpal tunnel syndrome in the hand, tarsal tunnel syndrome can cause heel pain.

 

Stress Fractures

Stress fractures of the calcaneus are an uncommon cause of heel pain. Stress fractures should be considered especially in athletes such as long distance runners who have heel pain.

 

Posterior Heel Pain

Posterior heel pain causes symptoms behind the foot, rather than underneath. Posterior heel pain causes include Achilles tendonitis and retrocalcaneal bursitis. Learn about causes of posterior heel pain and what treatments are available.

 

When do you need to call your doctor about your heel pain?

If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of heel pain must be directed at the specific cause of your problem.

 

Some signs that you should be seen by a doctor include:

  • Inability to walk comfortably on the affected side.
  • Heel pain that occurs at night or while resting.
  • Heel pain that persists beyond a few days.
  • Swelling or discoloration of the back of the foot.
  • Signs of an infection, including fever, redness, warmth.
  • Any other unusual symptoms.

Symptoms

Pain in the heel can result from a number of factors. Abnormalities of the skin, nerves, bones, blood vessels, and soft tissues of the heel can all result in pain. Because of walking and daily movement, we are always at risk for injury or trauma to the heel area. Common causes of pain in the heel include blisters and corns.

 

Plantar fasciitis, inflammation of the "bowstring-like" tissue in the sole of the foot stretching from the heel to the front of the foot, is one condition commonly associated with heel pain. Sometimes diseases that affect other areas of the body, like peripheral vascular disease or arthritis, can also result in pain in the foot or heel.

 

Sever's disease is a cause of heel pain in children that results from injury to the growth plate of the heel bone. Treatments for heel pain depend on the particular cause.

Causes

Most frequently heel pain is not the result of any single injury, such as a fall or twist, but rather the result of repetitive or excessive heel pounding.

 

Plantar fasciitis is inflammation of the thick connective tissue on the sole of your foot that attaches to your heel. The pain is usually felt at the bottom of your heel and is often worse in the morning because of stiffness that occurs overnight.

 

The following increase your risk of developing this painful problem:

 

  • Shoes with poor arch support or soft soles.
  • Quick turns that put stress on your foot.
  • Tight calf muscles.

 

Repetitive pounding on your feet from long-distance running, especially running downhill or on uneven surfaces.

 

Pronation - landing on the outside of your foot and rolling inward when walking or running; to know if you pronate, check the soles of your shoes to see if they are worn along the outer edge.

 

Bone spurs in the heel can accompany plantar fasciitis, but are generally not the source of the pain. If you treat the plantar fasciitis appropriately, the bone spur is likely to no longer bother you.

 

Heel bursitis (inflammation of the back of the heel) can be caused by landing hard or awkwardly on the heel, or by pressure from shoes.

 

Achilles tendinitis is inflammation of the large tendon that connects your calf muscle to your heel.

 

This can be caused by:

 

  • Running, especially on hard surfaces like concrete.
  • Tightness and lack of flexibility in your calf muscles.
  • Shoes with inadequate stability or shock absorption.
  • Sudden inward or outward turning of your heel when hitting the ground.

Treatment

Treatment of heel pain depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment plan.

 

Some common treatments for heel pain are listed here. Not all of these treatments are appropriate for every condition, but they may be helpful in your situation.

 

Rest

Avoiding the precipitating activity; for example, take a few day off jogging or prolonged standing/walking. Just resting usually helps to eliminate the most severe pain, and will allow the inflammation to begin to cool down.

 

Apply Ice Packs

Icing will help to diminish some of the symptoms and control the heel pain. Icing is especially helpful after an acute exacerbation of symptoms.

 

Exercises and Stretches

Exercises and stretches are designed to relax the tissues that surround the heel bone. Some simple exercises, performed in the morning and evening, often help patients feel better quickly.

 

Anti-Inflammatory Medications

Anti-inflammatory medications help to both control heel pain and decrease inflammation. Over-the-counter medications are usually sufficient, but prescription options are also available.

 

Shoe Inserts

Shoe inserts are often the key to successful treatment of heel pain. The shoe inserts often permit patients to continue their routine activities without heel pain.

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