Heel Pain: Causes and Treatment

Heel pain would have to be one of the most common problems that clients present with at our Redlands podiatry clinic.

heel pain

Heel pain affects all age groups and genders; it can involve either the bottom, sides, or back of the heel; and the pain can intensify at certain times of the day. Some people find it is worst when they first get out of bed, while others are affected at night, or after walking or running.

It can be puzzling because in a lot of cases, heel pain doesn’t follow an injury such as a sprain. Instead, it usually starts out as a mild irritation, becoming more severe – even disabling – over time.

Persistent heel pain usually won’t go away on its own; it may even be a sign of a rare yet serious condition known as osteomyelitis, so if heel pain has been troubling you for some time, please visit your local podiatry clinic.

What Causes Heel Pain?

Heel pain may be a symptom of a vast number of conditions, and may develop as a result of any of the following:

  • Physical Trauma – in the wake of an injury such as a sprained ankle, where ligament, tendon, bone, or nerve damage has been sustained (this is where foot mobilisation therapy may be of benefit).
  • Arthritis – usually associated with ageing, and a lifetime of wear and tear on the body – although genetic factors and old injuries may also be contributing factors.
  • Sever’s Disease – this is a growth-related condition, most commonly seen in very active children under the age of 12.
  • Autoimmune Disorders – eg rheumatoid arthritis.
  • Plantar Fasciitis – inflammation of the ligament which runs lengthways along the arch of your foot.
  • Heel Bursitis – a bursa is a fluid-filled sac which naturally occurs in the body, usually sitting between two structures as a cushion – for example, to prevent tendons from rubbing on bone. It can become inflamed as a result of injury or repetitive movement.
  • Achilles Tendonitis – a chronic long term irritation, caused by abnormal loads placed on the foot and heel. Achilles tendonitis usually develops as a result of wearing incorrect footwear, or by suddenly getting back into exercise and doing too much too soon.
  • Nerve Damage – such as tarsal tunnel syndrome. You might have heard of carpal tunnel syndrome in the wrist; the tarsal tunnel is located in the ankle region. It can arise as a result of abnormal foot mechanics, or perhaps due to systemic factors like rheumatoids.
  • Back problems – Pain in the heel may actually be “referred pain” – that is, stemming from a problem elsewhere in your body, eg your lower back, and then referred to your foot.
  • Heel Spurs – a bone-like growth which develops between the heel bone and the arch of your foot.
  • Gout – Contrary to popular opinion, gout doesn’t just affect the big toes – it can also cause heel pain. When there is too much uric acid in the bloodstream, it can crystallise and form deposits in the joints.

Less common but more serious causes of heel pain include ligament tears; nerve entrapment; circulatory problems; soft tissue matter such as lipomas and fibromas; an underactive thyroid; bone cysts; stress factors; and osteomyelitis (infection of the bone).

Treating Heel Pain

The first step in treating heal pain is to establish a possible cause. As a podiatrist, I will consider variables such as:

  • the age of the individual;
  • their preferred footwear, and if it is fit for purpose;
  • the surface or terrain upon which the pain is experienced;
  • the time of day when pain is at its worst;
  • lower limb alignment;
  • and the individual’s general health.

In the majority of cases, symptoms may be relieved with the application of ice, heat, calf stretching, rest, and wearing the appropriate footwear.

However to paraphrase the TV ads: “Should heel pain persist, please see your ‘foot doctor'” – your local podiatrist.