Heel pain: Causes and treatment

Heel pain: Causes and treatment

Heel pain is a common complaint that can develop for a variety of reasons. Heel pain may vary in severity from slightly bothersome to severe enough to interfere with everyday activities. But the good news is most causes of heel pain are treatable without invasive procedures.

Typical heel pain symptoms

Usually, the pain is felt on the bottom of the heel or back of the heel. Additional features of heel pain may include:

• Heel pain may be worse after sitting for a few hours and with few steps in the morning
• Pain may start gradually and become worse over time
• Pain may be worse after exercise

In certain cases, it is important to see a foot specialist immediately. Do not delay medical care if you experience any of the following symptoms:

• Significant pain
• Difficulty in walking
• Redness and burning on the heel 
• Swelling in the heel
• Heel pain that starts suddenly

Causes of heel pain 

Several conditions may cause heel pain, including those listed below.

Plantar fasciitis: One of the most frequent causes of heel pain is plantar fasciitis. It may develop due to inflammation of the ligament that runs across the bottom of the foot called the plantar fascia. People that participate in repeated high impact activities, such as basketball and running, are at an increased risk of the condition due to stress placed on the ligament.

Heel bursitis: Bursitis is another common cause of heel pain. Heel bursitis occurs when the bursa on the back of the heel becomes inflamed. It can develop due to wear and tear or from landing hard on the heel. Pressure for footwear may also increase the risk of heel bursitis. Heel pain from bursitis tends to become worse as the day progresses.

Achilles tendonitis: Achilles tendonitis develops when the tendon that attaches the heel to the calf becomes inflamed. The most common cause of Achilles tendonitis is from overuse from activities, such as running.

Heel spur: A heel spur occurs due to a calcium deposit that develops between the arch of the foot and the heel. Usually, it develops underneath the heel. But a heel spur may also affect other areas of the foot if left untreated. The deposits can grow to about a half-inch. But in other cases, a heel spur may be so small it is not visible to the naked eye. 

There are also less frequent causes of heel pain, such as:

• Infection
• Peripheral neuropathy
• Rupture of the Achilles tendon 
• Bone tumor
• Arthritis

Heel pain treatment 

Various types of treatment are available to treat heel pain. The treatment may vary depending on the cause and the severity of pain. In some cases, home treatment is enough to decrease heel pain. Home treatment may include:

Rest: Avoiding high impact activities until the pain subsides may help. 

Ice: Applying ice for 15 minutes a few times a day may reduce inflammation. 

Non-steroidal anti-inflammatory drugs: Non-steroidal anti-inflammatory medications may decrease swelling and pain. But take with caution since the drugs can also have unwanted side effects and interfere with other types of medications taken. 

Athletic taping: Taping may provide better foot support and reduce pain. Ask a foot specialist the best way to tape your foot for your condition.

Additional treatment as recommended by a podiatrist may include the following:

Orthotics: Orthotics provide foot and arch support and may help correct misalignment, which leads to heel pain. Custom made orthotics from a podiatrist may be the best option to provide relief for heel pain.

Extracorporeal shock wave therapy: If other treatments do not work, extracorporeal shock wave therapy might be a good option. Shockwave therapy stimulates revascularization to promote circulation. It may speed healing and decrease pain.  Most people may be able to have extracorporeal shock wave therapy, but there are some exceptions. For instance, it may not be recommended for people with bleeding disorders and local infections

Corticosteroid injections: Steroid injections can decrease inflammation. But they are not recommended for long-term use since they can have side effects, including damage to the tendons. 

If you have any questions about heel pain or other foot problems or would like to schedule an appointment, please contact Podiatrist, Sheldon Nadal, D.P.M at the Bayview-Eglinton Podiatry clinic in Toronto.