Heel Pain is one of the most common conditions treated by podiatrists. It is often a message from the body that something is in need of medical attention. Pain occurs right after an injury or early in an illness may play a protective role, often warning us about damage we have suffered.
Who gets heel pain?
The greatest incidence of heel pain is seen in middle-aged men and women. It is also seen in those who take part in regular sporting activities and those significantly overweight and on their feet a lot. Heel pain can also occur in children, usually between 8 and 13, as they become increasingly active in sporting activities.
The causes if heel pain
It is thought that higher arches or flatter arches, or feet that roll in too much are causes of heel pain. This can place too much stress on the heel bone and the soft tissues attached to it.
Systemic diseases such as arthritis and diabetes can also contribute to heel pain.
One factor sometimes associated with heel pain is the heel spur, a bony growth under the heel bone. There are no visible features on the heel, but a deep painful spot can be found in or around the middle of the sole of the heel.
Approximately 10 per cent of the population may have heel spurs without any pain.
Heel spurs result from strain on the muscles of the foot. This may result from biomechanical imbalance, a condition occurring in many people.
Both heel pain and heel spurs are frequently associated with an inflammation of the long band of tissue that connects the heel and the ball of the foot. The inflammation of this arch area is called plantar fasciitis.
The inflammation may be aggravated by shoes that lack appropriate support, especially in the arch area, and by the chronic irritation that sometimes accompanies an athletic lifestyle.
Other causes of heel pain
- Excessive rolling in of the feet when walking.
- An inflamed bursa (bursitis), a small, irritated sack of fluid at the back of the heel.
- A neuroma (a nerve growth).
- Other soft tissue growths.
- Heel bumps or “pump bumps” a bone enlargement at the back of the heel bone.
- Bruises or stress fractures to the heel bone.
Overcoming the Problem
If pain and other symptoms of inflammation – redness, swelling, heat-persist, you should limit normal daily activities and see one of our podiatrists. Depending on the symptoms and presentations we may conduct an x-ray or ultrasound to look for heel spurs, fractures or any soft tissue abnormality such as excessive thickening of the plantar fascia.
Early treatment might involve exercise and shoe recommendations, taping or strapping and anti-inflammatory medications (such as voltaren or aspirin). Taping or strapping supports the foot, placing stressed muscles in a restful state and preventing stretching of the plantar fascia. Other physical therapies may also be used, including massage, dry needling ice-packs and ultrasounds.
These treatments will effectively treat the majority of heel and arch pain without the need for surgery.
Only relatively few cases of heel pain require further intervention such as cortisone injections, PRP (platelet rich plasma) injections, shock wave therapy, iontiopherisis or in very rare cases surgery. We can provide you with all the information you will need, and guide you on the best choice of treatment for your condition.
If required, surgery is usually for the removal of a spur, but also may involve release of the plantar fascia, removal of a bursa, or a removal of a neuroma or other soft-tissue growth.
Your recovery will depend on the cause of your heel pain and your individual health. If you are suffering with a heel spur or plantar fasciitis, it normally takes about six or eight weeks for a healthy individual to fully recover. That is when the injured area is fully rested or properly strapped.
Preventing future problems
Wear shoes that fit well – front, back and sides – and have shock-absorbent soles, rigid uppers and supportive heel counters. Do not wear shoes with excessive wear on the heels or soles.
Stretching and exercise
Prepare properly before exercising, warm up before running or walking and do some stretching exercises afterwards.
Pace yourself when you participate in athletic activities. If overweight, try non weight-bearing activities such as swimming or cycling.
We may also use taping and strapping to provide extra support for your foot. And prescribe orthotics (shoe insoles) either off the shelf or custom made for your foot depending on your needs.