Heel pain is a common foot problem. Pain usually occurs under the heel or just behind it, where the Achilles tendon connects to the heel bone. Sometimes it can affect the side of the heel.
Pain that occurs under the heel is known as plantar fasciitis. This is the most common cause of heel pain.
Pain behind the heel is Achilles tendinitis. Pain can also affect the inner or outer side of the heel and foot.
In most cases, pain is not caused by an injury. At first, it is usually mild, but it can become severe and sometimes disabling. It usually disappears without treatment, but sometimes it can persist and become chronic.
Causes include arthritis, infection, an autoimmune problem, trauma, or a neurological problem.
When the plantar fascia is stretched too far, its soft tissue fibers become inflamed. This usually happens where it attaches to the heel bone, but sometimes it affects the middle of the foot. Pain is felt under the foot, especially after long periods of rest. Calf-muscle cramps may occur if the Achilles tendon tightens too.
Heel bursitis: Inflammation can occur at the back of the heel, in the bursa, a fibrous sac full of fluid. It can result from landing awkwardly or hard on the heels or from pressure from footwear. Pain may be felt deep inside the heel or at the back of the heel. Sometimes, the Achilles tendon may swell. As the day progresses, the pain usually gets worse.
Heel bumps: Also known as pump bumps, these are common in teenagers. The heel bone is not yet fully mature, and it rubs excessively, resulting in the formation of too much bone. It is often caused by having a flat foot. It can be caused by starting to wear high heels before the bone is fully mature.
Chronic inflammation of the heel pad: This is caused either by the heel pad becoming too thin, or through heavy footsteps.
Severs disease: This is the most common cause of heel pain in child and teenage athletes, caused by overuse and repetitive microtrauma of the growth plates of the heel bone. It most commonly affects children aged 7 to 15 years.
Achilles tendinosis: This is also known as degenerative tendinopathy, tendonitis, tendinosis, and tendinopathy. It is a chronic condition associated with the progressive degeneration of the Achilles tendon.
Sometimes the Achilles tendon does not function properly because of multiple, minor microscopic tears of the tendon, which cannot heal and repair themselves correctly. As the Achilles tendon receives more tension than it can cope with, microscopic tears develop. Eventually, the tendon thickens, weakens, and becomes painful.
Osteomyelitis may result from an injury or surgery, or the infection may get into bone tissue from the bloodstream. Symptoms include deep pain and muscle spasms in the inflammation area, as well as fever.
Peripheral neuropathy involves nerve damage, and it can lead to pain and numbness in the hands and feet.
It can result from traumatic injuries, infections, metabolic disorders, and exposure to toxins. Diabetes is a common cause.
Rheumatoid arthritis is a progressive and disabling auto-immune condition that causes inflammation and pain in the joints, the tissue around the joints, and other organs in the human body.
It usually affects the joints in the hands and feet first, but any joint may become affected.
A night splint may be fitted to the calf and foot and kept on during sleep. This holds the plantar fascia and Achilles tendon in a lengthened position overnight and stretches them.
These are available to buy online, but it is best to consult a medical professional before using them.
Treatment for heel bursitis
If it is possible to distinguish heel bursitis as a separate condition from plantar fasciitis, an effective treatment may be to use a cushioning insole or heel cup to limit the movements that are causing the problem.
Rest is also recommended, and a steroid injection may be needed.
Treatment for heel bumps
Inflammation behind the heel may be relieved with ice, compression and a change of footwear.
Achilles pads, tortoise and heel grip pads may offer temporary relief.
Cortisone injections may help with pain.
For most people, treatment will get rid of heel pain within 6 weeks. However, in severe cases, and if pain persists, surgery may be necessary.
Home care can help get rid of heel pain that is not severe.
Rest: Avoid running or standing for long periods, walking on hard surfaces, and any activities that may stress the heels.
Ice: Place an ice-pack wrapped in cloth on the affected area for about 15 minutes, but not directly onto the skin.
Footwear: Shoes that fit well and provide good support are crucial, especially for athletes.
Foot supports:Wedges and heel cups can help relieve symptoms.
Prevention of heel pain involves reducing the stress on that part of the body.
- wearing shoes when on hard ground, and not going barefoot
- maintaining a healthy body weight to reduce stress on the heels
- choosing footwear with heels made of material that can absorb some stress, or using inserted heel pads
- ensure shoes fit properly and do not have worn down heels or soles
- avoid shoes that seem to trigger pain
- rest your feet rather than standing if you are susceptible to heel pain
- warm up properly before engaging in sports and activities that may place lots of stress on the heels
- wear suitable sports shoes for each task