Heel Pain

What is heel pain?

Heel pain is a common problem that troubles people of all ages. There are many different types and causes of heel pain, but if your heels hurt, you probably are very aware of it. Your heel pain may have started days, weeks, or even months ago. At first you may have felt a dull ache that didn’t last. For some people, heel pain worsens as the day goes on. For others, it’s a sharp jab that strikes every time the heel touches the ground. Heel pain may be the worst when you get out of bed in the morning, causing you to hobble for a few steps or a few minutes. In any case, heel pain can make standing or walking unbearable.

What causes heel pain?

Heel pain may be caused by the way your feet move or by the way your legs and feet are built. It also can result from an injury or a medical problem that affects your entire body. For many people, heel pain is part of aging. It shows up after your feet have supported you through years of daily wear and tear. To achieve the best long-term results, your podiatrist treats not only your heel pain but also the underlying cause of your problems.

Ligament And Tendon Problems
If your heel moves too much or too little, it can cause other parts of your foot to function incorrectly. Over time, stress from poor foot function can stretch or tear the ligaments or tendons in your heel. In some people, the constant demands of daily use are enough to weaken these tissues. Being overweight may aggravate such problems. Ligament and tendon injuries can also result from a direct blow or a sudden twist. Treatment goals for tissue problems include reducing abnormal pull on the ligaments and tendons.

Bone Problems
When incorrect heel movement strains tissue, it also increases stress on the bones in your heel and ankle. Over time, excess strain may change the structure of your foot, causing damage and heel pain. In addition, injury from a direct blow or the effects of arthritis can damage bones (and joints), causing pain. Treatment goals include reducing abnormal stress on bones.

Nerve Problems
Nerves are bundles of special fibers that act like electric wires, passing signals between your brain and your feet. When a nerve is pinched—by inflamed tissue or a swollen vein—some or all of the signals can’t travel their complete routes. As a result, you may feel pain, numbness, or tingling in your heel. Even a nerve pinched in your back may send abnormal signals (referred pain) to your heel. Treatment goals for these types of problems include reducing pressure on the affected nerve.

Treating heel pain

Depending on your problem, your podiatrist may recommend one or more types of treatment. Medication, physical therapy, and exercise promote proper healing and may be all the care you’ll need. However, for many people with movement problems or uneven leg lengths, custom-made shoe inserts (orthoses) provide the most lasting results. In some cases, surgery offers the best solution. Your podiatrist will discuss the treatment plan with your physician if an ongoing health problem is contributing to your heel pain.

Immediate Care
Your podiatric treatment plan begins with immediate care to reduce pain and swelling. Then, the underlying cause of your heel pain is treated. You can do some things at home to lessen swelling, such as applying RICE (Rest, Ice, Compression, and Elevation).

Medication
Your podiatrist may suggest taking aspirin or ibuprofen to control pain. To control extreme inflammation or pain, your podiatrist may inject cortisone, an anti-inflammatory medication.

Strapping
Straps of tape can be applied to reduce the pull on tissues and help support bones and joints. If strapping is helpful, orthosis may be prescribed alone or with other treatment.

Physical Therapy
Your podiatrist may recommend ultrasound, deep heat, or water therapy. These forms of physical therapy all increase circulation and aid in healing one, joint, and tissue problems.  Your podiatrist also may recommend exercises to stretch and strengthen the tissues in your feet. Do the exercises in your bare feet to get the full benefit.

Foot Gear
Wearing foot gear that meets your needs can improve the way your feet feel. Shoes with laces, such as running shoes, provide some side-to-side support.

Orthosis
Custom-made from impressions of your feet, orthoses can improve foot movement or compensate for uneven leg length.

Surgery
Your podiatrist may suggest surgery to release tight ligaments or pinched nerves. Surgery may also be performed to smooth sections of bone.