How do you get heel pain?
Your feet are designed to handle a lot of stress. You put 60 tons of stress on each foot with every mile you walk. The heel bone is the largest bone in the foot. Abusing your feet by running or wearing shoes that irritate your feet can cause heel pain. Most heel pain is caused by overuse. Pain in your heel can also result from injury or structural issues in your foot.
What is heel pain?
Heel pain can be caused by abnormalities in your walking gait that stress the heel bone and the soft tissues attached to it. It may also be caused by injury, overuse, wearing improper footwear, or being overweight. The most common causes of heel pain are:
Plantar fasciitis is an inflammation of the fibrous band of tissue on the bottom of the foot that supports your arch. Anyone can develop plantar fasciitis, but it is most common in the following people:
- People with diabetes
- Pregnant women
- Tennis players
- Volleyball players
- People who are obese
- Athletes who undergo intense training
Plantar fasciitis symptoms include intense heel pain with the first few steps you take when you first wake up. The pain often improves with walking throughout the day but may return in the afternoon or evening.
A heel spur occurs when you have an abnormal growth on the heel bone where it attaches to the plantar fascia. It can be related to plantar fasciitis, but this is not always the case. Runners and people who are obese are particularly at risk of developing heel spurs.
Many people have heel spurs with no symptoms. When heel spurs do cause pain, it is typically located on the undersurface of the heel. Pain may worsen over the course of several months.
Calcaneal apophysitis is most common in active children between the ages of 8 and 14. Irritation develops in the center of the heel due to increased activity or new shoes. Children who engage in sports that involve a lot of jumping are most at risk of developing calcaneal apophysitis. In children with this condition, the lower back part of the heel is sore to the touch but isn’t swollen.
Bursitis is an inflammation of one of the over 150 bursae located in the human body. These jelly-like sacs cushion the joints and allow for easier movement.
Bursitis in the heel can occur on the underside or back of your heel. People with an abnormal walking gait may be at risk for bursitis. It can also be caused by shoes without adequate heel cushioning. Symptoms of bursitis include pain in the middle of the bottom of your heel. The pain gets worse as you bend your foot up or down.
Posterior calcaneal exostosis
This calcaneal spur is also known as a pump bump. It is a bony overgrowth at the back of the heel.
Women who wear pumps are at increased risk of developing this condition. It is often the result of long-term bursitis that develops from wearing high-heeled shoes. The main symptom of pump bump is pain at the location of the bony growth, especially when you wear shoes that put pressure there.
Like all parts of the body, the heel is susceptible to bruising from an injury. Heel pain from bruising is usually the result of stepping on a hard object, often referred to as a stone bruise. Symptoms of bruising on your heel include pain, swelling, soreness, and black and blue discoloration of the skin.
Achilles tendonitis is an inflammation of the Achilles tendon. It’s usually caused by overuse, especially by jumping a lot during sports. It can also be caused by shoes that don’t fit properly.
This type of heel pain can also be caused by an inflammatory illness such as rheumatoid arthritis or gout, but this is not very common. The main symptom of Achilles tendonitis is pain at the back of the heel. This pain is usually worse if you exercise. You may also have soreness, stiffness, and swelling.
This is caused by the compression of a small nerve. A trapped nerve can cause pain, numbness, or tingling in your heel area. If you have a sprain, fracture, or varicose vein near the heel, it may cause a trapped nerve. If the trapped nerve was caused by a fracture or sprain, you may have other symptoms, such as bruising or swelling.
Diagnosis for heel pain
Only a licensed health care professional can diagnose the exact cause of your heel pain. Your doctor will listen to your symptoms and medical history. A physical exam may be enough for them to diagnose the cause of your heel pain. If it isn’t, you may need to undergo further imaging studies such as X-rays.
Treatments for heel pain
The treatment for your heel pain will depend on the cause. Here are some common treatments for the following diagnoses:
Treatment for plantar fasciitis usually includes rest, stretching exercises, ice massage, and taping the sole of the foot. You may also be advised to take acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen for pain relief. Surgery is not usually necessary.
Heel spurs are often treated with shoe inserts and local corticosteroid injections.
This condition usually goes away on its own. Your doctor may recommend rest and heel pads or cushions.
Bursitis is treated similarly to heel spurs with shoe inserts and corticosteroid injections. It may be necessary to change your footwear as well.
Posterior calcaneal exostosis
This is also treated with shoe inserts and corticosteroid injections. Surgery to remove the bony growth may be necessary, but this is rare.
Bruises are typically treated with an ice pack shortly after the injury occurs.
This is treated with rest, physical therapy, and NSAIDs.
Usually this is treated by healing the underlying problem that caused it. This may be a fracture, sprain, or varicose vein. Though unlikely, surgery may be needed to release the nerve.
Possible complications and side effects
Some treatments for heel pain can have risks and side effects. Several common side effects include:
Nonsteroidal anti-inflammatory drugs
- Stomach ulcers
- Allergic reaction
- In rare cases, liver, kidney, or heart problems
- Pain around the injection site for a few days
- Loss of fat around the site of injection
- Increased blood sugar level if you have diabetes
- Increased blood pressure if you have high blood pressure
- Infection that causes redness, swelling, and pain
Health Solutions From Our Sponsors
American Family Physician: "Diagnosing Heel Pain in Adults."
American Podiatric Medical Association: "Heel Pain."
Harvard Health Publishing: "Heel Pain."
NHS: "Steroid Injections."
OrthoInfo: "Heel Pain."
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