Heel Pain

Overview

Heel pain is often felt on the bottom or back of the foot. Although heel pain is seldom associated with an underlying medical problem, it may significantly impair daily activities, especially exercise.

Pain typically originates beneath the heel or slightly behind it. The pain usually feels at the site of the Achilles tendon that is attached to the heel bone.

In most cases, heel pain develops gradually and becomes more severe with time. Generally, the affected area remains physically uninjured. The plantar fascia might become inflamed and irritated as a result of the tension generated by flat shoes. The discomfort, on the other hand, might be intense if there is a tear.

Symptoms may worsen in the morning and after a period of rest during the day, but may lessen with moderate physical activity later in the day. They may have deteriorated again by the end of the day.

Plantar fasciitis is the most common cause of stabbing heel pain. It is known as heel spur syndrome when there is a spur present. Heel pain may also be caused by fractures, nerve irritation, tendonitis, arthritis, or a cyst on the bottom of the foot.

Due to the wide range of potential causes of heel pain, it is essential that the problem be properly diagnosed. A foot and ankle surgeon can distinguish between the many types of heel pain and identify the source of the problem.

Pain in the heel of the foot is a common sign of foot and ankle issues. Stretching, rest and orthotics may help reduce pain over time. If you ignore heel pain for a long period of time, you risk developing chronic problems that will take more time to repair.

Causes

Some of the heel pain causes are discussed below:

Inflammation or Plantar fasciitis: The bowstring-like ligament i.e. plantar fascia runs the length of the foot and connects the heel bone to the toes.

The soft tissue fibers become inflamed when the ligament is strained. This is most common around the tendon’s connection to the heel bone, although it may also happen in the middle of the foot. Pain in the bottom of the heel is common, especially after extended periods of inactivity. Tightening of the Achilles tendon leads to calf muscle cramps.

Bursitis: Inflammation of the bursa which is a fibrous sac filled with fluid near the back of the heel, may cause sharp pain in the heel. This may happen as a result of a painful or severe fall on the heels. Moreover, pressure from footwear is also responsible for causing this inflammation. As a consequence, there is a pain in the back of the heel. The tendon may sometimes expand leading to Achilles heel pain that increases throughout the day.

Heel bumps: It is a common occurrence during adolescence.Since the heel bone is not fully grown and rubs excessively, it results in an excessive bone creation. Frequently, this condition is caused by a flat foot. This problem can occur when a person wears high heels prior to the bone fully forming.

Tarsal tunnel syndrome: In this condition, the main nerve near the back of the foot becomes entrapped. This entrapment of the nerve causes pain. Compression neuropathy of the ankle or foot leads to heel pain when walking.

Stress fracture: Repetitive stress, sports, strenuous exercise, and physical labor have all been linked to this condition. Stress fractures are common in runners due to the pressure on metatarsal bones. Pain in the side of the heel may occur due to stress. Osteoporosis is also a contributing factor for stress and thereby leading to pain in the back of the feet.

Achilles tendinosis: Chronic Achilles tendon degeneration is a long-term disorder in which the tendon deteriorates. A series of small tears in the Achilles tendon that are unable to mend and repair themselves may result in the tendon becoming dysfunctional. Tiny tears happen when the Achilles tendon is stretched beyond its capacity to absorb tension. The tendon is likely to grow and weaken over time, making it uncomfortable to use. It can cause heel pain while running.

Some other conditions and factors associated with heel pain are listed below:

• Bruised heel or heel injury
• Osteomyelitis
• Bone spurs
• Gout
• Bone cyst
• Rheumatoid arthritis

Symptoms

Typical heel pain symptoms include soreness or pain in the back or underside of the heel. Sharp or stabbing pain, soreness, and swelling are common symptoms. Heel discomfort is frequently worse in the first few steps after waking up in the morning or after extended periods of relaxation. It can also be increased by activities that put extra strain on the heel, such as running or standing for long periods. One of the most common causes of heel pain is plantar fasciitis, inflammation of the tissue that runs along the sole and joins to the heel bone.

Diagnosis

A medical evaluation by a healthcare expert, often a podiatrist or orthopedic specialist, is required to diagnose heel discomfort. The heel pain diagnosis includes:

• A detailed medical history.
• A discussion of symptoms.
• A physical examination of the foot to measure pain and range of motion.

Imaging studies such as X-rays or ultrasound may be required to rule out fractures or other structural abnormalities in the heel.

Treatment

The underlying cause determines  heel pain treatment, but it is expected to begin with conservative methods. Rest and reduced activity, as well as icing the affected area, can help lessen symptoms. Supportive footwear with cushioned insoles or orthotics can offer relief and reduce heel strain. To enhance flexibility, calf and Achilles tendon stretching activities may be recommended. Ibuprofen, a non prescription pain medication, may help manage pain and inflammation. Physical treatment or corticosteroid injections may be considered in severe or persistent cases. Surgical intervention may be required in rare circumstances. Effective treatment seeks to alleviate pain, promote healing, and prevent heel discomfort from recurring.

When To See A Doctor

If you are experiencing persistent heel pain for more than a week despite the efforts to alleviate it, you should seek medical attention. Consult a doctor if you experience severe heel pain with swelling, numbness, or tingling in the heel. In case of experiencing any of the following symptoms, immediately consult your primary care physician:

• Fever
• Inability to walk normally
• Difficulty bending the foot downward
• Difficulty in standing on tiptoe
• Stiffness in heels

Disclaimer

This information is intended for educational purposes only and should not be considered a substitute for professional medical advice. If you have concerns about heel pain or any other medical condition, please see a doctor for an accurate diagnosis and personalized treatment suggestions.