People of all ages can experience heel pain, which is a typical complaint. Heel pain can result from two different types of injuries: sprains and fractures. It may also come on by a few illnesses, such as bursitis and reactive arthritis. How the treatment gets delivered may depend on the cause.
Overuse or injury to your heel may result in heel pain. It could be minor or harmful. You may need to see a doctor or podiatrist to identify the issue if simple home remedies are ineffective in relieving your pain.
This article examines how to diagnose heel pain, a common orthopedic symptom, as well as its rare causes. In addition to discussing various treatments, including physiotherapy, surgery, and simple rest and pain medication, it also provides advice on how to avoid heel pain.
Where does the pain in the heel start?
Anywhere in the heel, you could feel pain, soreness, or tenderness.
Usually, you experience heel pain;
- Behind the heel.
- Beneath the heel.
- Within the heel bone itself.
Causes of behind the heel pain:
The following issues may result in behind the heel pain;
- Achilles tendinopathy
The Achilles tendon is a fibrous band that connects the heel bone to the calf muscle. It is the body’s longest and strongest tendon. Achilles tendinitis is more common in runners and basketball players. The overuse injury results in inflammation of the tendons. Tendinitis causes the back of the heel to ache, swell, and stiffen.
- Bursitis
The plural of bursa is the bursae which are sacs with fluid inside that inflame to produce bursitis. Through support joints, these sacs allow smooth movement. It’s possible for the back of your heel to feel tender and bruised. Usually, bursitis appears after prolonged standing.
- Haglund’s malformation
The formation of an enlarged bony bump in the back of the heel, known as a pump bump, can be caused on by persistent inflammation and irritation. Pumps and other shoes with higher heels may aggravate the pain and bump.
- Calcaneal apophysitis, or Sever’s disease:
Children between the ages of 8 and 14 who are active often experience heel pain due to Sever’s disease. Youngsters who engage in sports that involve a lot of sprinting and leaping are more likely to this issue. An increase in physical activity aggravates the heel’s growth plate.
Causes of beneath the heel pain:
The following concerns can result in pain beneath the heel;
- Contusion or bone bruising
The fat that covers the heel may get bruised if you step on something hard or sharp. Even though there might not be any discoloration, walking will cause your heel to feel tender. Both Sever’s disease and a stress fracture can hurt the heel all the way around, on the side, back, and bottom.
- Plantar fasciitis
It happens when the connective tissue, also known as fascia, stretches or tears along the plantar surface of the foot. This severe condition is more common in athletes and heavy jumpers. Common sources of irritation include hard surfaces (like concrete) used for work or exercise, as well as treadmills.
- Spurs on the heels
A bone growth on the heel bone called a heel spur may develop as a result of persistent plantar fasciitis. Although some people experience pain, heel spurs are typically not painful.
Signs and symptoms of Heel Pain:
The location and reason of your heel injury will impact which part of your heel hurts and how severe it is. It’s also possible that different people experience pain in different ways. A dull, persistent ache may be the only sensation experienced by some, while others may feel severe or stabbing. The pain could be constant, sporadic, or worse when standing, walking, or during specific hours of the day, like the morning.
If you think you may have heel pain, keep an eye out for these symptoms;
- Swelling or redness
- The heel’s underside having a bulge or hump
- Stiffness or tightness, especially after being inactive
- Pain that originates in the heel and flows to other areas of the foot or leg
- Feeling tingly or sensitive
- Having trouble standing, moving, or running
- Pain worsens during physical activity or prolonged standing
Diagnosis:
For most heel problems, a physical examination and medical history are enough for diagnosis. In certain cases, blood tests and imaging exams might be necessary.
Past Medical History:
When diagnosing heel pain, a complete medical history is frequently the most important thing to consider.
Here are a few cases of these questions;
- You are in pain, and where exactly?
- Since when did you experience pain?
- What sensation does the ache give you?
- Is it painful for you to put weight on it?
- Does the pain get better or worse during the day or night?
- What actions do you remember performing that might have injured your foot?
- Do you experience any new symptoms?
Physical Inspection:
During the physical examination, the doctor will examine and palpate your foot, ankle, and heel to check for any abnormalities, bruises, rashes, or pain. They may also move (manipulate) your foot and ankle to see if and where you are experiencing pain.
The doctor may also decide to evaluate your gait by observing the position and preference of your foot, ankle, and heel.
Imaging exploration:
An X-ray of the heel may be required to diagnose conditions such as Haglund’s syndrome, stress fractures, heel spurs, and bone tumors. For soft tissue injuries and infections, magnetic resonance imaging (MRI) scans are less common diagnostic methods.
Differential Diagnoses:
It seems reasonable to believe that your heel would be the source of your pain, but this isn’t always the case. Plantar fasciitis, Achilles tendinitis, and other conditions may resemble the symptoms of heel pain.
These include;
- Radiculopathy:
When a pinched spinal nerve refers pain from one part of the body to another, this condition occurs. When there is lower back pain, it can also radiate down the calf muscle and into the heel.
- Peripheral nerve injury:
Peripheral neuropathy, defined by experiences of burning or pins-and-needles, can be caused on by damage to the nerves supplying the limbs. Among the causes are diabetes, alcoholism, and some medications.
- Skin problems:
In addition, bacterial and fungal skin diseases like athlete’s foot (like cellulitis) and plantar warts can cause heel pain.
Treatment:
Thankfully, there are a number of ways to relieve heel pain. There are various methods for treating heel pain, depending on what is causing it and how severe your symptoms are.
Non-Surgical:
Conservative measures are usually enough in reducing heel pain and promoting healing.
Your physician may suggest;
- Taking breaks from intense exercise and allowing your body to recover from it.
- Try taking up low-impact activities like swimming or cycling.
- To help reduce inflammation, use cold packs to your heels several times a day for 20 minutes at a time.
- Using non-steroidal anti-inflammatory medications (NSAIDs), or over-the-counter analgesics, like Aleve (naproxen) or Advil (ibuprofen)
- Putting on over-the-counter orthotics with insoles, such as heel cups or pads
- Selecting footwear with enough cushioning and arch support
- To relieve stiffness while you sleep at night, try stretching your Achilles tendon or plantar fascia.
- Placing kinesiology tape (KT) on your foot to support the arches of your heels.
Physiotherapy:
The tissues around the heel bone can be relaxed with specialized stretches and exercises like calf raises and sliding a plastic bottle filled with ice under the foot. These are done in the morning and the evening as part of a physiotherapy treatment plan.
By causing muscular contractions in the soft tissues, applying an ultrasound machine to the heels can help increase blood flow while reducing inflammation and heel pain.
Surgical:
Surgery is typically recommended only in cases where conservative measures have failed after six to twelve months of treating heel pain.
Patients with plantar fasciitis may undergo a surgical procedure called a plantar fascia release, which removes the plantar fascia from the heel bone. An alternative procedure called a gastrocnemius resection lengthens the calf muscle surgically to treat plantar fasciitis.
Risk factors for heel pain:
Whatever puts a lot of pressure and strain on the foot has the potential to cause heel pain. Additional factors include your foot’s shape (foot structure) and the way you walk (foot mechanics).
Heel pain may be more likely to take place if you;
- Have obesity or are overweight.
- Having tense muscles in your calves
- Show high arches in their feet, flat feet, or arthritis in their ankles.
- For exercise or in sports, run or jump a lot.
- Stand for extended periods of time, especially on concrete floors.
- Put on ill-fitting shoes that lack comfort or arch support.
What are the possible complications of heel pain?
You may find it difficult to move around, work, exercise, and finish everyday tasks if you have heel pain. You may become sedentary if moving causes you pain. Weight gain can result from a sedentary lifestyle. The inability to do the things you enjoy can also lead to depression.
Achilles tendinitis left untreated can lead to tendinosis, or the breakdown of the tendon. With time, the Achilles tendon could split or break down. Surgery might be required for fixing this problem.
Prevention:
There are steps you can take to protect your heel and the tissues that support it, whether or not you have previously suffered from heel pain.
- Control your weight: Having extra weight increases the strain on your lower body, particularly your heels.
- Put on the proper shoes: Wearing right, well-fitting shoes with sufficient support and comfort is essential for many types of heel pain.
- Before you do anything, warm up. This is particularly important if you’re heading for a long run or engaging in a strenuous activity.
Pain is never “normal,” so pay attention to your body’s cues. Take a step back and see if your heel pain improves if it is strange. If it gets worse or comes back, get medical advice.
Managing Heel Pain:
Chronic heel pain that lasts longer than a few months can make daily living difficult, even though it usually goes away with rest and proper treatment.
Here are a few strategies for managing chronic pain;
- Observe your doctor’s recommended course of action:
By following to your physician’s provider’s recommendations for self-care techniques, medication, physiotherapy, and lifestyle modifications, heel pain can be managed and the chance of complications decreased.
- Experiment with multiple pain-management techniques:
Try utilizing a variety of pain-reduction and relaxation techniques, such as breathing exercises, meditation, and visualization.
- Continue to be active at this level:
Low-impact activities that help you stay in shape and avoid stiffness, like stretching, cycling, or swimming, can help you experience less heel pain.
- Stretch:
To help prevent pain from getting worse and to improve range of motion, apply stretching exercises for your ankles and feet into your daily routine.
- Rest and healing should be your top priorities:
Pay attention to your body and take breaks throughout the day as needed.
When should I consult a doctor?
If heel pain doesn’t go away after two weeks or if the patient has any of the following symptoms, they should see a doctor.
- Terrible pain and edema around the heel
- Heel pain, tingling, or numbness, fever, and trouble walking normally
- Difficulty stepping or bending the foot downward
If the heel pain lasts longer than a week or gets worse when the person isn’t standing or walking, they should see a doctor.
What is the prognosis for individuals experiencing heel pain?
Heel pain is typically relieved non surgically, although recovery takes time. You have to be patient and let your body heal itself. Resuming regular activities too soon may cause you to heal more slowly. You won’t usually require surgery.
Summary:
In conclusion, heel pain affects people of all ages and is a common problem. The most common cause of heel pain is inflammation of the band of tissue that runs along the bottom of the foot, called the plantar fascia, or plantar fasciitis. Particularly when taking your first steps in the morning or standing up from a seated position, this inflammation may cause sudden, severe pain. Achilles tendinitis, or inflammation of the tendon that attaches the calf muscle to the heel bone, and bursitis, or inflammation of the fluid-filled sacs that support the surrounding muscles, tendons, and bones, are two more conditions that can cause heel pain.
A multitude of factors, such as obesity, incorrect footwear, and overuse, can result in heel pain. Rest, ice, and over-the-counter painkillers are the usual treatments for heel pain. Rarely, rehabilitation or injections of corticosteroids may be necessary. It’s important to see a doctor if you’re having heel pain so that you can discuss treatment options and receive a diagnosis.
Heel pain that is diagnosed and treated early can help to speed up recovery and keep the condition from getting worse. There are several things you can do to help relieve heel pain and get better if you’re experiencing it. These include putting on supportive shoes, icing the injured area, and resting your foot. Try physiotherapy or stretching exercises as well.
FAQ:
How can I stop feeling pain in my heel?
Try to get as much rest as you can for at least a week. About twice a day, for ten to fifteen minutes, apply ice to the painful area. For pain and inflammation, take ibuprofen or acetaminophen. For support in your heel, you can purchase felt pads, shoe inserts, or a heel cup if necessary.
What could be the cause of heel pain?
Obesity, poorly fitting shoes, running and jumping on hard surfaces, unusual walking gait patterns, injuries, and specific illnesses are among the common causes of heel pain. The inflammation of the plantar fascia, which runs the entire length of the foot, typically comes on by overstretching.
Is uric acid the cause of heel pain?
A form of arthritis called gout comes on by an increase of uric acid crystals in the joints. The big toe is one of the most common locations for gout, but it can also affect other joints, such as the heel. Heel pain from gout attacks can be extremely painful and impairing.
Can heel pain be relieved by walking?
If running or jogging is the cause of your heel pain, it’s essential to refrain from doing this kind of demanding exercise while you recover. You can temporarily replace walking for running because daily walks help to stretch your plantar fascia and calf muscles.
Is there a remedy for heel pain?
The majority of the time, heel pain is treatable at home. Try to spend as much time as possible sleeping for at least a week if you can. For ten to fifteen minutes, apply ice to the sore spot twice a day on average. Acetaminophen or ibuprofen should be taken for pain and inflammation.
How can I naturally lessen my heel pain?
Exercise: Regular foot stretches prevent the plantar fascia muscles from pulling and stiffening, which makes it easier for the heel to support the weight of the body when you move.
Massage: For those with plantar fasciitis, applying pressure to the foot’s trigger points may help them feel less pain.
Does heat help with heel pain?
By improving blood flow and circulation, heat therapy helps lessen stiffness and cramping. Additionally, heat has the potential to relax the plantar fascia ligament, improving the results of massage and stretching. Heat, however, can increase swelling and doesn’t reduce pain.
Is ice beneficial for heel pain?
Pain related to the condition may be lessened by reducing inflammation. Plantar fasciitis can be treated by applying ice to the injured tissue, massaging the area, or combining the two methods two to three times a day for five to ten minutes at a time.
What are the muscles in your heel?
The foot muscles called the abductor hallucis and abductor digit minimi are located on the sides of the heel bone. These are the muscles that, in turn, flex and move the big toe (first toe) and the fifth toe. The heel bone is also home to the origin of the Achilles tendon, which joins the calf and its muscles to the heel.
Will the pain in my heel go away?
As your muscles relax and blood flow increases, your heel pain might lessen, but this will probably only be a temporary solution. Over time, symptoms can be reduced and walking-related heel pain can be eliminated with the right care and prevention.
A heel splint: what is it?
A night splint is a good way to treat heel pain and is comfortable to sleep in. By keeping the foot in one position while you sleep, you can give the plantar fascia ligament and Achilles tendon a continuous stretch, which is often used to help relieve heel pain. A night splint looks like an illuminated boot.
What foods can I eat to relieve my heel pain?
Vitamin C: Inflammation is the root cause of many foot conditions, such as tendinitis and plantar fasciitis. Fortunately, vitamin C has anti-inflammatory properties. Thus, make an effort to eat a variety of foods high in vitamin C, such as spinach, kale, oranges, tomatoes, kiwis, and strawberries.
Is pain in the heel temporary?
In most cases, heel pain resolves on its own with home remedies. If you have mild heel pain, consider the following: Go to bed. Avoid activities like running, prolonged standing, and walking on hard surfaces if at all possible as they can cause stress on your heels.
What is the heel’s nerve?
Baxter’s nerve entrapment: Injections Guided by Ultrasound
Located along the inside of the heel, the Baxter’s nerve, also referred to as the first branch of the lateral plantar nerve, is a tiny nerve with a diameter of less than 1 mm. Even though it is a rare cause of heel pain, you should still take it into consideration if your discomfort does not go away, especially if you have been told you have plantar fasciitis.
References:
- L. Curtis (2024b, Jan. 23). How Can Heel Pain Be Relieved? What Causes It? Wellness. https://www.health.com/8423065/heel-pain
- D. Burke (2024b, Feb. 7). Why Do You Have Heel Pain? Prevention of Heel Pain: https://www.healthline.com/health/heel-pain
- J. Cluett (2024b, 25 April). How is heel pain treated and what causes it? Verywell Medical. Finding the cause of heel pain: https://www.verywellhealth.com/heel-pain-information-and-causes-2549378#toc
- A. Virani (2024b, 28 May). The causes, remedies, and preventative advice for heel pain. Exercise and Physical Therapy Treatment. heel pain at physical-therapy.us
- Expert, C. C. M. (n.d.-a). Cleveland Clinic: Heel Pain. heel pain article from https://my.clevelandclinic.org/health/articles/10060
- January 12, 2024: Brazier, Y. What triggers heel pain and how to treat it. 181453, https://www.medicalnewstoday.com/articles