Bone & Joint Expert Care
When walking, your heels repeatedly hit the ground with considerable force. They have to be able to absorb the impact and provide a firm support for the weight of the body.
When pain develops in the heel, it can be very disabling, making every step a problem, affecting your posture.
There are various types of heel pain. Some of the most common are: heel spurs (plantar fasciitis); heel bursitis and heel bumps.
Heel Spurs: the pain is usually worst on standing, particularly first thing in the morning when you get up. It is relatively common, though usually occurring in the over forty's age group. There are no visible features on the heel but a deep localised painful spot can be found in or around the middle of the sole of the heel. Although it is often associated with a spur of bone sticking out of the heel bone (heel spur syndrome), approximately ten per cent of the population have heel spurs without any pain.
Heel Bursitis: pain can be felt at the back of the heel when the ankle joint is moved and there may be a swelling on both sides of the Achilles tendon. Or you may feel pain deep inside the heel when it makes contact with the ground.
Heel Bumps: recognised as firm bumps on the back of the heel , they are often rubbed by shoes causing pain.
Heel Spurs: cushioning for the heel is of little value. Your chiropodist/podiatrist may initially apply padding and strapping to alter the direction of stretch of the ligament. This is often successful at reducing the tenderness in the short term. Your chiropodist/podiatrist may suggest a course of deep heat therapy to stimulate the healing processes, allowing damage to respond and heal faster. In the long term, your chiropodist/podiatrist may prescribe special insoles (orthoses) to help the feet to function more effectively, thereby reducing strain on the ligaments and making any recurrence less likely.
If pain from heel spurs continues, you may be referred to your GP who can prescribe an oral non-steroidal anti-inflammatory. Alternatively, localised hydrocortisone injection treatment may be given by your GP or an appropriate chiropodist/podiatrist. If pain persists, surgery may be considered.
Heel Bursitis: in most cases, attention to the cause of any rubbing, and appropriate padding and strapping by your chiropodist/podiatrist will allow the inflammation to settle. If infection is present, your chiropodist/podiatrist will refer you to your GP for antibiotics.
Heel Bumps: adjustments to footwear is often enough to make them comfortable. A leather heel counter and wearing boots may help. However, if pain persists, surgery may be necessary.
What is it?
Heel pain is most commonly caused by plantar fasciitis, an inflammatory condition of the thick band of tissue on the sole of the foot, which is known as the plantar fascia.
The heel pain of plantar fasciitis is often worst with the first few steps in the morning and can increase with standing and after exercising.
Causes of heel pain
Biomechanical abnormalities that cause the foot to abnormally pronate (roll in) on walking are the cause of most cases of plantar fasciitis. Sometimes painful outgrowths of bone called heel spurs form where the plantar fascia joins the heel bone, however, these are not the primary source of the heel pain.
Treatment of heel pain
Treatment for plantar fasciitis may include rest, stretching, applying ice, anti-inflammatory medicines and weight loss to reduce stresses on the feet. If necessary, foot supports, strapping or orthotics may be recommended to correct structural abnormalities of the foot.