Heel pain is a very common foot problem. The sufferer usually feels pain either under the heel (planter fasciitis) or just behind it (Achilles tendinitis), where the Achilles tendon connects to the heel bone. Even though heel pain can be severe and sometimes disabling, it is rarely a health threat. Heel pain is typically mild and usually disappears on its own; however, in some cases the pain may persist and become chronic (long-term). There are 26 bones in the human foot, of which the heel (calcaneus) is the largest. The human heel is designed to provide a rigid support for the weight of the body. When we are walking or running it absorbs the impact of the foot when it hits the ground, and springs us forward into our next stride. Experts say that the stress placed on a foot when walking may be 1.25 times our body weight, and 2.75 times when running. Consequently, the heel is vulnerable to damage, and ultimately pain.
There are many reasons why people experience heel pain. Based on what we see in our office, heel pain affects, probably more than one in every four people. A lot of this is caused from conditions within the foot. These conditions could be related to hyper pronation, which is where you get a collapse of the foot or even a high arch of the foot called cavus foot. The underlying cause is something internal, within the bone structure. These problems are usually something you will have all your life. Hyper pronation is a hereditary issue where you can get an under development of a particular bone, usually in the ankle, and it causes a dislocation or a misalignment of the ankle on the heel. It throws off, not only the foot with the bones, joints and ligaments of the foot, but also the bones in the ankle. It affects the internal rotation of the knee, hip, back and causes issues within those areas as well. Hyper pronation is a pretty common, but very under diagnosed condition.
The heel can be painful in many different ways, depending on the cause. Plantar fasciitis commonly causes intense heel pain along the bottom of the foot during the first few steps after getting out of bed in the morning. This heel pain often goes away once you start to walk around, but it may return in the late afternoon or evening. Although X-ray evidence suggests that about 10% of the general population has heels spurs, many of these people do not have any symptoms. In others, heel spurs cause pain and tenderness on the undersurface of the heel that worsen over several months. In a child, this condition causes pain and tenderness at the lower back portion of the heel. The affected heel is often sore to the touch but not obviously swollen. Bursitis involving the heel causes pain in the middle of the undersurface of the heel that worsens with prolonged standing and pain at the back of the heel that worsens if you bend your foot up or down. Pump bump, this condition causes a painful enlargement at the back of the heel, especially when wearing shoes that press against the back of the heel. Heel bruises, like bruises elsewhere in the body, may cause pain, mild swelling, soreness and a black-and-blue discoloration of the skin. Achilles tendonitis, this condition causes pain at the back of the heel where the Achilles tendon attaches to the heel. The pain typically becomes worse if you exercise or play sports, and it often is followed by soreness, stiffness and mild swelling. A trapped nerve can cause pain, numbness or tingling almost anywhere at the back, inside or undersurface of the heel. In addition, there are often other symptoms, such as swelling or discoloration - if the trapped nerve was caused by a sprain, fracture or other injury.
In most cases, your GP or a podiatrist (a specialist in foot problems and foot care) should be able to diagnose the cause of your heel pain by asking about your symptoms and medical history, examining your heel and foot.
Non Surgical Treatment
Treatment of heel pain generally occurs in stages. At the earliest sign of heel pain, aggressive calf muscle stretching should be started. Additionally, taking an oral anti-inflammatory medication and over-the- counter arch supports or heel cushions may be beneficial. The next phase of treatment might consist of continued calf muscle stretching exercises, cortisone injections and orthopedic taping of the foot to support the arch. If this treatment fails, or if there is reoccurrence of the heel pain, then functional foot orthotics might be considered. A functional orthotic is a device that is prescribed and fitted by your foot doctor, which fits in normal shoes like an arch support. Unlike an arch support, however the orthotic corrects abnormal pronation of the subtalar joint. Thus orthotics address the cause of the heel pain - abnormal pronation of the foot. Pump bump, treatment is similar to the treatment of bursitis and heel spurs. In rare cases, the bony growth at the heel may need to be removed surgically. Heel bruises can be treated by applying an ice pack for the first few minutes after injury. Achilles tendonitis, this condition is treated conservatively with rest, NSAIDs and physical therapy. If a sprain, fracture or other injury has caused the trapped nerve, this underlying problem must be treated first. In rare cases, surgery may be done to release the trapped nerve.
Only a relatively few cases of heel pain require surgery. 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.
how to get rid of heel spurs
Wearing real good, supportive shoes are a great way to avoid heel pain. Usually, New Balance is a good shoe to wear, just for everyday shoe gear. By wearing proper footwear and performing thorough stretches, athletes can help prevent frequent heel pain. If you are starting to get a little discomfort or pain in the feet or heel, know that pain is not normal. So if you are having pain, you should be proactive and visit our office. If you let heel pain get out of control you could run into several other problems. It is always suggested to visit a podiatrist whenever you are experiencing pain.