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Heel pain is a common foot condition. It usually builds up gradually, getting worse over time. What are the causes of heel pain?
Most cases of heel pain have a mechanical cause. Other causes include:
Mechanical Heel pain Plantar Fasciitis Most commonly pain is usually worst in the morning, or when you take a step after a period of inactivity. The pain improves after walking but can worsen after standing for long periods. Most types of heel pain is caused by the tough and flexible band of tissue that runs underneath the foot can become inflamed and thickened, known as Plantar Fasciitis. Damage can occur suddenly, when out running or dancing or can occur over many months or years of micro-tears, often affecting the 40 plus age group. Increased risk You are at an increased risk of gradual wear and tear damaging your plantar fasciitis if you are:
Less common causes of heel pain are Stress fracture A stress fracture can occur if your heel bone (calcaneum) is damaged during an injury. |
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Fat pad atrophy
Fat pad atrophy is where the layer of fat that lies under the heel bone, known as the fat pad, starts to waste away due to too much strain being placed on the pad. Women who wear high-heeled shoes for many years have an increased risk of developing fat pad atrophy.
Bursitis
Bursitis is inflammation of one or more bursa (small fluid-filled sacs under the skin usually found over the joints and between tendons and bones).
It is possible to develop bursitis anywhere inside the body, not just in the foot.
Tarsal tunnel syndrome
The nerves in the sole of your foot pass through a small tunnel on the inside of the ankle joint, known as the tarsal tunnel. If a cyst forms or the tunnel is damaged, the nerves can become compressed (squashed). This can cause pain anywhere along the nerve, including beneath your heel.
Non-Mechanical Heel Pain
Sever's disease
Sever's disease is a common cause of heel pain in children. It is caused by the muscles and tendons of the hamstrings and calves stretching and tightening in response to growth spurts. The stretching of the calf muscle pulls on the Achilles tendon. This pulls on the growing area of bone at the back of the heel (growth plate), causing pain in the heel.The pain is further aggravated by activities such as football and gymnastics. The pain often develops at the side of the heel, but can also be felt under the heel. Calf and hamstring stretches and, if necessary, heel pads are usually effective treatments for Sever's disease.
Tarsal tunnel syndrome
Tarsal tunnel syndrome can be caused from mechanical or non-mechanical causes so maybe leave it under mechanical but with a note that there are also non-mechanical causes such as arthritis or diabetes which can cause swelling, thus resulting in nerve compression or an enlarged or abnormal structure, such as a varicose vein or ganglion cyst, that might compress the nerve.
How is Heel pain diagnosed?
In most cases the relevant healthcare professional, GP, chiropodist / podiatrist, physiotherapist or osteopath can diagnose it by first taking a thorough history and then examining the foot and leg.
Treatment for Heel Pain
There are a number of treatments that can help relieve heel pain and speed up your recovery. These include:
Around four out of five cases of heel pain resolve within a year. However, having heel pain for this length of time can often be frustrating and painful. In around one in 20 cases, the above treatments are not enough and surgery may be recommended to release the plantar fascia.
Preventing Heel Pain
Being overweight can place excess pressure and strain on your feet, particularly on your heels. Loosing weight and maintaining a healthy weight by combining regular exercise can be beneficial for your feet.
Wearing appropriate footwear is also important. Ideally, you should wear shoes with a low to moderate heel that supports and cushions your arches and heels. Ideally, you should wear shoes with laces and a low to moderate heel that supports and cushions your arches and heels. Avoid wearing shoes with no heels.
You should always wear footwear that is appropriate for your environment and day-to-day activities. Wearing high heels all week at work may damage your feet, particularly if your job involves a lot of walking or standing.
Do not walk barefoot on hard ground, particularly while on holiday. Many cases of heel pain occur when a person protects their feet for 50 weeks of the year and then suddenly walks barefoot while on holiday. Their feet are not accustomed to the extra pressure, which causes heel pain.
If you do a physical activity, such as running or another form of exercise that places additional strain on your feet, you should replace your sports shoes regularly.
Also see:
General Foot Conditions and Care
Fungal Nail and Athletes Foot
Please read our disclaimer.
Fat pad atrophy is where the layer of fat that lies under the heel bone, known as the fat pad, starts to waste away due to too much strain being placed on the pad. Women who wear high-heeled shoes for many years have an increased risk of developing fat pad atrophy.
Bursitis
Bursitis is inflammation of one or more bursa (small fluid-filled sacs under the skin usually found over the joints and between tendons and bones).
It is possible to develop bursitis anywhere inside the body, not just in the foot.
Tarsal tunnel syndrome
The nerves in the sole of your foot pass through a small tunnel on the inside of the ankle joint, known as the tarsal tunnel. If a cyst forms or the tunnel is damaged, the nerves can become compressed (squashed). This can cause pain anywhere along the nerve, including beneath your heel.
Non-Mechanical Heel Pain
Sever's disease
Sever's disease is a common cause of heel pain in children. It is caused by the muscles and tendons of the hamstrings and calves stretching and tightening in response to growth spurts. The stretching of the calf muscle pulls on the Achilles tendon. This pulls on the growing area of bone at the back of the heel (growth plate), causing pain in the heel.The pain is further aggravated by activities such as football and gymnastics. The pain often develops at the side of the heel, but can also be felt under the heel. Calf and hamstring stretches and, if necessary, heel pads are usually effective treatments for Sever's disease.
Tarsal tunnel syndrome
Tarsal tunnel syndrome can be caused from mechanical or non-mechanical causes so maybe leave it under mechanical but with a note that there are also non-mechanical causes such as arthritis or diabetes which can cause swelling, thus resulting in nerve compression or an enlarged or abnormal structure, such as a varicose vein or ganglion cyst, that might compress the nerve.
How is Heel pain diagnosed?
In most cases the relevant healthcare professional, GP, chiropodist / podiatrist, physiotherapist or osteopath can diagnose it by first taking a thorough history and then examining the foot and leg.
Treatment for Heel Pain
There are a number of treatments that can help relieve heel pain and speed up your recovery. These include:
- resting your heel – try to avoid walking / running long distances and standing for long periods
- regular stretching – stretching your calf muscles and plantar fascia
- pain relief – using an icepack on the affected heel and taking painkillers, and such as non-steroidal anti-inflammatory drugs (NSAIDS)
- wearing good-fitting shoes that support and cushion your foot, particularly the heel – running shoes are particularly useful
- using supportive devices such as orthoses (rigid supports you put inside your shoe)
- strapping the foot, a short term measure. This can be done by our Physiotherapists, Osteopaths or Podiatrists.
Around four out of five cases of heel pain resolve within a year. However, having heel pain for this length of time can often be frustrating and painful. In around one in 20 cases, the above treatments are not enough and surgery may be recommended to release the plantar fascia.
Preventing Heel Pain
Being overweight can place excess pressure and strain on your feet, particularly on your heels. Loosing weight and maintaining a healthy weight by combining regular exercise can be beneficial for your feet.
Wearing appropriate footwear is also important. Ideally, you should wear shoes with a low to moderate heel that supports and cushions your arches and heels. Ideally, you should wear shoes with laces and a low to moderate heel that supports and cushions your arches and heels. Avoid wearing shoes with no heels.
You should always wear footwear that is appropriate for your environment and day-to-day activities. Wearing high heels all week at work may damage your feet, particularly if your job involves a lot of walking or standing.
Do not walk barefoot on hard ground, particularly while on holiday. Many cases of heel pain occur when a person protects their feet for 50 weeks of the year and then suddenly walks barefoot while on holiday. Their feet are not accustomed to the extra pressure, which causes heel pain.
If you do a physical activity, such as running or another form of exercise that places additional strain on your feet, you should replace your sports shoes regularly.
Also see:
General Foot Conditions and Care
Fungal Nail and Athletes Foot
Please read our disclaimer.