Heel Pain

Heel Pain Has Many Causes

Heel pain is generally the result of abnormal biomechanics of the foot which places a tremendous amount of pressure on the heel bone and its surrounding soft tissue attachments. These stresses can also occur as a result of injury or continuous micro trauma that can occur while walking, running, or jumping. Poor footwear and obesity can also lead to heel pain. Often various disease processes can accompany heel pain.

Heel Spurs

A heel spur is a small bony growth on the heel bone that can sometimes cause heel pain. A spur can occur on the bottom or the back of the heel bone. It is generally visible on X-ray as a protrusion on the heel bone. They can be as small as a few millimeters to as large as half an inch.

The heel bone has a long ligament (called plantar fascia) that attaches from the heel bone to the ball of the foot. The continuous strain on the ligament causes the formation of bony growth on the heel bone.

Plantar Fasciitis

Both heel pain and heel spur are frequently associated with the inflammation of the plantar fascia. This inflammation is called plantar fasciitis. It occurs when the plantar fascia is strained beyond its normal extension causing the fibers to tear or stretch along its length. This trauma leads to inflammation of the fascia.

The pain can be aggravated by shoes that lack proper support especially in the arch of the feet. Rest only provides temporary relief but when you resume walking the pain comes back. As you walk, the pain may go away or get better, but it often returns with prolonged rest or excessive walking.

Disease and Heel Pain

Some general health conditions can also bring about heel pain.

• Rheumatoid arthritis and other forms of arthritis, including gout, which usually manifests itself in the big toe joint, can cause heel discomfort in some cases.
• Heel pain may also be the result of an inflamed bursa (bursitis), a small, irritated sack of fluid; a neuroma (a nerve growth); or other soft-tissue growth. Such heel pain may be associated with a heel spur, or may mimic the pain of a heel spur.
• Haglund's deformity ("pump bump") is a bone enlargement at the back of the heel bone, in the area where the Achilles tendon attaches to the bone. This sometimes painful deformity generally is the result of bursitis caused by pressure against the shoe, and can be aggravated by the height or stitching of a heel counter of a particular shoe.
• Pain at the back of the heel is associated with inflammation of the achilles tendon as it runs behind the ankle and inserts on the back surface of the heel bone. The inflammation is called achilles tendonitis. It is common among people who run and walk a lot and have tight tendons. The condition occurs when the tendon is strained over time, causing the fibers to tear or stretch along its length, or at its insertion on to the heel bone. This leads to inflammation, pain, and the possible growth of a bone spur on the back of the heel bone. The inflammation is aggravated by the chronic irritation that sometimes accompanies an active lifestyle and certain activities that strain an already tight tendon.
• Bone bruises are common heel injuries. A bone bruise or contusion is an inflammation of the tissues that cover the heel bone. A bone bruise is a sharply painful injury caused by the direct impact of a hard object or surface on the foot.
• Stress fractures of the heel bone also can occur, but these are less frequent.

Children’s Heel Pain

Heel pain can also occur in children, most commonly between ages 8 and 13, as they become increasingly active in sports activity in and out of school. This physical activity, particularly jumping, inflames the growth centers of the heels; the more active the child, the more likely the condition will occur. When the bones mature, the problems disappear and are not likely to recur. If heel pain occurs in this age group, podiatric care is necessary to protect the growing bone and to provide pain relief. Other good news is that heel spurs do not often develop in children.

Prevention

A variety of steps can be taken to avoid heel pain and accompanying afflictions:

• Wear shoes that fit well — front, back, and sides — and have shock-absorbent soles, rigid shanks, and supportive heel counters.
• Wear the proper shoes for each activity.
• Do not wear shoes with excessive wear on heels or soles.
• Prepare properly before exercising. Warm up and do stretching exercises before and after running.
• Pace yourself when you participate in athletic activities.
• Don’t underestimate your body's need for rest and good nutrition.
• If obese, lose weight.

Treatment Options

If pain and other symptoms of inflammation-redness, swelling, heat-persist, you should limit normal daily activities and contact us for a comprehensive evaluation and personalized treatment option. We will examine the area and may perform diagnostic X- rays to rule out problems of the bone.

Early treatment might involve oral or injectable anti-inflammatory medication, exercise and shoe recommendations, taping or strapping, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used in conjunction with such treatments.

A functional orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and tendons attaching to the heel bone. It will effectively treat the majority of heel and arch pain without the need for surgery.

Only a relatively few cases of heel pain require more advanced treatments or surgery. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of a neuroma or other soft-tissue growth.

If you are thinking about surgery or have heel pain that is not responding to any treatment options, see us NOW. We have state of the art new in office treatment option which has helped thousands avoid surgery and find relieve. Call us today for your personalized and confidential consultation.