What are the common causes of heel pain. How can you treat heel pain at home. When should you see a doctor for heel pain. What are the professional treatment options for persistent heel pain. How can you prevent heel pain from occurring or recurring.

Understanding the Anatomy of the Heel

The human foot is a complex structure, consisting of 26 bones, 33 joints, and over 100 tendons. At the heart of this intricate system lies the heel, which is the largest bone in the foot. This remarkable composition allows for the versatility and strength required for daily activities, but it also makes the heel susceptible to various forms of pain and injury.

The heel bone, or calcaneus, serves as the anchor point for several important structures:

• The Achilles tendon, which connects the calf muscles to the heel
• The plantar fascia, a thick band of tissue that runs along the bottom of the foot
• Various ligaments that provide stability to the ankle and foot

Understanding this anatomy is crucial for comprehending the various causes of heel pain and the most effective treatment approaches.

Common Causes of Heel Pain

Heel pain can arise from a variety of sources, ranging from acute injuries to chronic conditions. Identifying the underlying cause is essential for proper treatment and relief. Here are some of the most frequent culprits:

Plantar Fasciitis

Plantar fasciitis is perhaps the most common cause of heel pain. It occurs when the plantar fascia, the ligament that connects your heel to your toes, becomes inflamed due to excessive strain or overuse. This condition often manifests as a sharp pain in the bottom of the heel, especially when taking the first steps in the morning or after prolonged periods of rest.

Achilles Tendonitis

When the Achilles tendon becomes inflamed or irritated, it can lead to pain at the back of the heel. This condition, known as Achilles tendonitis, is often the result of repetitive stress or sudden increases in physical activity. Athletes and runners are particularly susceptible to this type of heel pain.

Heel Spurs

Heel spurs are bony protrusions that develop on the underside of the heel bone. While not always painful, they can cause discomfort when walking or standing for extended periods. Heel spurs often develop in conjunction with plantar fasciitis.

Bursitis

The retrocalcaneal bursa is a small, fluid-filled sac that cushions the Achilles tendon where it attaches to the heel bone. When this bursa becomes inflamed, it can cause pain and swelling in the heel area. This condition, known as bursitis, can result from repetitive motions or ill-fitting footwear.

Stress Fractures

Tiny cracks in the heel bone, known as stress fractures, can develop over time due to repetitive impact or sudden increases in activity levels. These fractures can cause persistent heel pain that worsens with weight-bearing activities.

Diagnosing Heel Pain: When to See a Doctor

While mild heel pain can often be managed at home, certain symptoms warrant professional medical attention. It’s important to recognize these signs to ensure timely and appropriate treatment.

You should consult a healthcare provider if you experience:

• Severe pain that limits your daily activities
• Heel pain that persists for more than two to three weeks despite home treatment
• Sudden onset of intense heel pain
• Visible swelling or redness in the heel area
• Pain accompanied by fever or tingling sensations
• Inability to bear weight on the affected foot

During your appointment, the doctor will likely perform a physical examination and may order imaging tests such as X-rays, MRI scans, or ultrasounds to determine the exact cause of your heel pain. This diagnostic process is crucial for developing an effective treatment plan tailored to your specific condition.

Home Remedies for Heel Pain Relief

For mild to moderate heel pain, several home remedies can provide relief and promote healing. These conservative treatments are often the first line of defense against heel discomfort:

Rest and Ice Therapy

Resting the affected foot is crucial for allowing the tissues to heal. Applying ice to the heel for 15-20 minutes, several times a day, can help reduce inflammation and alleviate pain. Always wrap the ice pack in a thin towel to protect your skin from direct contact with the cold.

Stretching Exercises

Gentle stretching exercises can help improve flexibility and reduce tension in the plantar fascia and Achilles tendon. Try these simple stretches:

• Toe stretches: Gently pull your toes back towards your shin and hold for 30 seconds
• Calf stretches: Lean against a wall with your affected leg straight behind you, heel on the ground
• Rolling stretch: Roll a frozen water bottle or tennis ball under your foot for 1-2 minutes

Supportive Footwear

Wearing shoes with proper arch support and cushioning can significantly reduce heel pain. Consider using orthotic inserts or heel cups to provide additional support and distribute pressure more evenly across your foot.

Over-the-Counter Pain Relievers

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help reduce pain and inflammation. Always follow the recommended dosage and consult your healthcare provider if you have any concerns about using these medications.

Professional Treatment Options for Persistent Heel Pain

When home remedies fail to provide adequate relief, professional medical interventions may be necessary. Healthcare providers have a range of treatment options at their disposal to address persistent heel pain:

Physical Therapy

A physical therapist can design a customized exercise program to strengthen the muscles supporting your foot and ankle, improve flexibility, and promote proper biomechanics. They may also use techniques such as ultrasound therapy or manual manipulation to alleviate pain and promote healing.

Custom Orthotics

Unlike over-the-counter inserts, custom orthotics are specially designed to address your unique foot structure and gait pattern. These devices can provide targeted support and help distribute pressure more evenly across your foot, reducing strain on the heel.

Corticosteroid Injections

For severe or persistent pain, your doctor may recommend corticosteroid injections directly into the affected area. These injections can provide significant pain relief and reduce inflammation, although their effects are typically temporary.

Extracorporeal Shock Wave Therapy (ESWT)

This non-invasive treatment uses sound waves to stimulate healing in the affected tissues. ESWT can be particularly effective for chronic plantar fasciitis that has not responded to other conservative treatments.

Surgical Interventions

In rare cases where conservative treatments have failed to provide relief, surgery may be considered. Surgical options can include plantar fascia release, heel spur removal, or tendon repair, depending on the underlying cause of the pain.

Preventing Heel Pain: Proactive Measures for Foot Health

While not all cases of heel pain can be prevented, there are several steps you can take to reduce your risk and maintain optimal foot health:

Proper Footwear

Invest in well-fitting shoes that provide adequate arch support and cushioning. Replace your shoes regularly, especially if you engage in high-impact activities. For athletes, choosing sport-specific footwear can help prevent injuries related to improper support.

Gradual Activity Progression

When starting a new exercise routine or increasing your activity level, do so gradually. Sudden increases in intensity or duration can put excessive stress on your feet and lead to injuries. Follow the 10% rule: increase your activity by no more than 10% per week.

Maintain a Healthy Weight

Excess body weight puts additional stress on your feet and can contribute to heel pain. Maintaining a healthy weight through proper diet and regular exercise can help reduce this stress and lower your risk of foot-related issues.

Cross-Training

Varying your exercise routine can help prevent overuse injuries. If you’re a runner, for example, incorporate low-impact activities like swimming or cycling into your routine to give your feet a break while still maintaining your fitness level.

Regular Stretching

Incorporate foot and ankle stretches into your daily routine, even when you’re not experiencing pain. This can help maintain flexibility and reduce the risk of developing conditions like plantar fasciitis.

Understanding the Long-Term Outlook for Heel Pain

The prognosis for heel pain varies depending on the underlying cause and the individual’s response to treatment. Many cases of heel pain resolve with conservative management within a few months. However, some conditions may require ongoing management or have a tendency to recur.

Factors that can influence the long-term outlook include:

• The specific cause of the heel pain
• How quickly treatment is initiated
• Adherence to treatment recommendations
• Individual factors such as age, overall health, and activity level

It’s important to work closely with your healthcare provider to develop a comprehensive treatment plan and follow-up care strategy. This may involve periodic check-ups, adjustments to your treatment approach, and ongoing preventive measures to maintain foot health.

Exploring Alternative and Complementary Therapies for Heel Pain

In addition to conventional medical treatments, some individuals find relief from heel pain through alternative and complementary therapies. While scientific evidence for these approaches may be limited, some people report benefits from:

Acupuncture

This traditional Chinese medicine technique involves inserting thin needles into specific points on the body. Some studies suggest that acupuncture may help reduce pain and improve function in individuals with plantar fasciitis.

Massage Therapy

Deep tissue massage or reflexology may help alleviate tension in the muscles and fascia of the foot, potentially reducing pain and improving flexibility.

Herbal Remedies

Certain herbs with anti-inflammatory properties, such as turmeric or ginger, are sometimes used topically or consumed to help manage pain and inflammation. However, it’s important to consult with a healthcare provider before using any herbal supplements, as they can interact with medications or have side effects.

Mind-Body Techniques

Practices like yoga or tai chi can help improve overall body awareness, flexibility, and balance, which may contribute to better foot health and pain management.

While these alternative approaches may provide relief for some individuals, it’s crucial to discuss them with your healthcare provider before incorporating them into your treatment plan. They should be used in conjunction with, not as a replacement for, evidence-based medical treatments.

In conclusion, heel pain is a common but manageable condition that can significantly impact daily life. By understanding its causes, recognizing when to seek professional help, and implementing appropriate treatment and prevention strategies, most individuals can find relief and maintain optimal foot health. Remember that each case is unique, and working closely with healthcare professionals is key to developing an effective, personalized approach to managing heel pain.

Heel Pain: Causes, Treatments, and Prevention

Heel Pain: Causes, Treatments, and Prevention

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Heel pain can result from injuries like sprains and fractures. Some medical conditions, including bursitis and reactive arthritis, may also cause it. Treatment can depend on the cause.

Your foot and ankle are made up of 26 bones, 33 joints, and more than 100 tendons. The heel is the largest bone in your foot.

If you overuse or injure your heel, you may experience heel pain. This can range from mild to disabling. It’s possible you’ll need to have a doctor or podiatrist diagnose the cause if simple home remedies don’t ease the pain.

There are several common causes of heel pain.

• Plantar fasciitis. Plantar fasciitis occurs when too much pressure on your feet damages the plantar fascia ligament, causing pain and stiffness. Find out what causes this condition and possible treatment options.
• Sprains and strains. Sprains and strains are injuries to the body, often resulting from physical activity. These injuries are common and can range from minor to severe, depending on the incident. Learn more about sprains and strains.
• Fracture. A fracture is a broken bone. This condition is considered a medical emergency. Urgent care may be required. Know what symptoms to look for and who’s at risk.
• Achilles tendonitis. Achilles tendonitis occurs when the tendon that attaches the calf muscles to the heel becomes painful or inflamed due to overuse injuries. Find out how this condition is diagnosed and treated.
• Bursitis. Bursae are fluid-filled sacs found about your joints. They surround the areas where tendons, skin, and muscle tissues meet bones.
• Ankylosing spondylitis. This form of arthritis primarily affects your spine. It causes severe inflammation of the vertebrae that might eventually lead to chronic pain and disability. Read more about ankylosing spondylitis.
• Osteochondroses. These disorders directly affect the growth of bones in children and adolescents. Learn more about the different types of osteochondroses.
• Reactive arthritis. An infection in the body triggers this is a type of arthritis. Find out more about its causes, symptoms, and possible treatments.

If you develop heel pain, you may first try some home remedies, such as rest, to ease your symptoms. If your heel pain doesn’t get better within two to three weeks, you should make an appointment with your doctor.

You should call your doctor immediately if you experience the following:

• Your pain is severe.
• The pain starts suddenly.
• You have redness in your heel.
• You have swelling in your heel.
• You can’t walk because of the pain in your heel.

If you develop heel pain, you can try these methods at home to ease your discomfort:

• Rest as much as possible.
• Apply ice to the heel for 10 to 15 minutes twice a day.
• Take over-the-counter pain medications.
• Wear shoes that fit properly.
• Wear a night splint, a special device that stretches the foot while you sleep.
• Use heel lifts or shoe inserts to reduce pain.

If these home care strategies don’t ease your pain, you need to see your doctor. They’ll perform a physical exam and ask you about your symptoms and when they began. Your doctor may also take an X-ray to determine the cause of your heel pain. Once your doctor knows what’s causing your pain, they’ll be able to provide you with the appropriate treatment.

In many cases, your doctor may prescribe physical therapy. This can help to strengthen the muscles and tendons in your foot, which helps to prevent further injury. If your pain is severe, your doctor may provide you with anti-inflammatory medications. These medications can be injected into the foot or taken by mouth.

Your doctor may also recommend that you support your foot as much as possible — either by taping the foot or by using special footwear devices.

In very rare cases, your doctor may recommend surgery to correct the problem, but heel surgery often requires a long recovery time and may not always relieve your foot pain.

Heel pain can be disabling and affect your daily movements. It may also change the way that you walk. If this happens, you may be more likely to lose your balance and fall, making you more prone to other injuries.

It may not be possible to prevent all cases of heel pain, yet there are some easy steps that you can take to avoid injury to the heel and prevent pain:

• Wear shoes that fit properly and support the foot.
• Wear the right shoes for physical activity.
• Stretch your muscles before exercising.
• Pace yourself during physical activity.
• Maintain a healthy diet.
• Rest when you feel tired or when your muscles ache.
• Maintain a healthy weight.

Last medically reviewed on December 18, 2017

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Heel pain. (n.d.).
  apma.org/learn/FootHealth.cfm?ItemNumber=985
• Mayo Clinic Staff. (2016). Heel pain.
  mayoclinic.com/health/heel-pain/MY00081
• Weatherford BM. (2017). Heel pain.
  orthoinfo.aaos.org/topic.cfm?topic=a00159

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Apr 21, 2023

Written By

Darla Burke

Edited By

Heather Hobbs

Dec 18, 2017

Medically Reviewed By

William Morrison, MD

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Medically reviewed by William Morrison, M.D. — By Darla Burke — Updated on April 21, 2023

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Heel Spurs: Symptoms, Causes, and Prevention

Overview

A heel spur is a foot condition that’s created by a bony-like growth, called a calcium deposit, that extends between your heel bone and arch.

Heel spurs often start in the front of and underneath your heel. They eventually affect other parts of your foot. They can get up to half an inch in length. They may not necessarily be visible to the naked eye.

Detecting heel spurs can be challenging. Heel spurs don’t always cause pain, and not all heel pain is related to spurs. Keep reading to learn more about these bony growths and what causes them.

Symptoms of heel spurs may include:

• pain
• inflammation
• swelling at the front of your heel

The affected area may also feel warm to the touch. These symptoms may spread to the arch of your foot. Eventually, a small bony protrusion may be visible.

Some heel spurs may cause no symptoms at all. You may also not see any changes in soft tissues or bones surrounding the heel. Heel spurs are often discovered only through X-rays and other tests done for another foot issue.

Heel spurs are directly caused by long-term muscle and ligament strain. Eventually, this excessive strain stresses the heel bone (calcaneus) causing spurs.

Heel spurs develop over time. They don’t suddenly appear after a workout or a sports event. Heel spurs tend to occur when you ignore early symptoms like heel pain.

Repetitive stress from walking, running, or jumping on hard surfaces is a common cause of heel spurs. They may also develop from wearing shoes that don’t support your foot.

Heel spurs may also be caused by:

• arthritis
• bruising of the heel
• excess body weight
• poorly fitted shoes
• walking gait issues
• wearing flip-flops too often
• worn-out shoes

Many people who have heel spurs also have plantar fasciitis. This painful condition deals with the tough, fibrous tissue that runs between your heel and toes. Having plantar fasciitis increases your risk for eventually developing heel spurs.

[Q&A WIDGET:

Q: What’s the difference between heel spurs and plantar fasciitis?

A: There’s a distinct difference between a heel spur and plantar fasciitis, but the two are closely related. A heel spur is a bony projection that occurs from the bottom of the heel along the course of the plantar fascia. It will vary in size but is usually not larger than half an inch. A heel spur may have no symptoms associated with it. It’s often discovered on an X-ray.

Plantar fasciitis is a painful condition in which there’s an inflammatory process occurring where the plantar fasciitis attaches to the heel. This occurs because of an abnormal force being placed on it. Excess weight, overuse, or wearing shoes without a supporting arch can cause an abnormal force.

As a general rule, plantar fasciitis will subside on its own over a period of time regardless of the treatment. A heel spur will be there permanently, unless surgery is required. Fortunately, surgery is rarely needed.

— William Morrison, MD

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

]

It’s difficult for you diagnose a heel spur without medical assistance. This is because the symptoms are similar to other forms of heel pain and foot problems.

You’ll need to see a specialist, such as an orthopedic surgeon or a podiatrist, for a proper diagnosis. They can then detect a heel spur through an X-ray. You can book an appointment with an orthopedist in your area using our Healthline FindCare tool.

Bony protrusions aren’t usually visible to the naked eye. That’s why diagnostic imaging tools are essential if you’re experiencing any unknown causes of foot pain and inflammation.

Before ordering imaging tests, your doctor will conduct a physical examination of your foot to look for any signs of redness or inflammation. Your doctor will also check for any noticeable tenderness on the foot. Tenderness is another indication of a heel spur.

Your podiatrist may also have you do physical tests, such as standing on one foot at a time, as well as taking a brief walk.

Heel spur treatment primarily consists of rest and lifestyle changes. Talk to your doctor about the following treatment options for heel spurs.

Cold compresses

Using ice packs or cold compresses for up to 15 minutes at a time may help relieve heel spur pain by temporarily numbing the area. This method also helps reduce swelling. Cold compresses are preferable over heat packs for heel spurs because heat works better for joint and muscle aches.

Injections of anti-inflammatory medications

For severe pain, your podiatrist may recommend corticosteroid shots. These anti-inflammatory injections help to ease both pain and inflammation throughout the heel and arch of the foot.

Over-the-counter pain medications

Acute, or short-term, pain may be reduced with the help of over-the-counter (OTC) pain medications. These may include acetaminophen (Tylenol), aspirin, or ibuprofen (Advil, Motrin).

Tell your doctor if you’re taking any other medications, such as blood thinners, or if you have any preexisting liver or kidney problems that could prevent you from taking OTC pain relievers.

Physical therapy exercises and stretching exercises

Your podiatrist may recommend physical therapy as a way to learn and practice exercises to prevent long-term pain, especially since anti-inflammatory medications can only be safely taken for a short amount of time.

Heel spur exercises consist of stretching the heel and plantar fascia muscles. Your physical therapist can show you how to do some of the exercises at home. These can be performed at any time of the day, but stretches can be especially helpful at night before bedtime.

Rest

Rest is one of the most recommended treatment measures for both plantar fasciitis and heel spurs.

Not only does rest help alleviate acute pain, but getting off your feet can also prevent your condition from worsening. It’s especially important to rest the feet after long periods of standing and other activities.

In the case of acute pain from a heel spur, your podiatrist may ask you to rest your foot until your symptoms subside. Putting weight on your heel while it’s in pain will likely worsen your condition. It could also lengthen your recovery time.

Orthotic shoe inserts

Orthotic shoe inserts, such as heel pads, can help give you the arch and heel support needed to reduce pain. Heel pads can also prevent further wear and tear. They should be used in addition to proper footwear for all-around foot protection.

Your doctor may recommend surgery when heel spur pain becomes severe and ongoing. This type of surgery involves removing the heel spur. Sometimes it also involves releasing the plantar fascia.

Heel spur surgery not only reduces pain, but it’s also aimed at boosting mobility in the overall foot. Most people who have this type of surgery also have plantar fasciitis. Due to other forms of treatments and therapies available, surgery is not common for heel spurs alone.

Before recommending heel spur surgery, your doctor will determine if you’re a proper candidate by conducting final imaging tests via X-rays and EKGs, as well as blood flow tests to the foot.

It will also take time for you to fully recover from heel spur surgery so that you’re able to put weight on your foot again. The recovery process might include:

• resting your foot and using ice
• compression
• supportive gear

Stretching exercises are good methods of overall body conditioning because they help you work out sore muscles and tight ligaments while also preventing injuries. The same concept applies to heel spur pain management and recovery.

Certain types of stretches can help improve pain and inflammation in your heel and calf areas. These include:

• calf stretches against the wall
• calf stretches on steps
• golf/tennis ball foot rolls
• seated foot flexes
• towel grabs with your toes

Try these eight exercises to ease pain from heel spurs.

Certain essential oils may act as natural anti-inflammatories to reduce both pain and swelling. They may also be massaged into your heels for further relief.

Some of the most notable anti-inflammatory essential oils include:

• bergamot oil
• eucalyptus oil
• fennel oil
• lavender oil
• orange oil
• rosemary oil
• sesame oil
• thyme oil

While studies are still being done to evaluate their anti-inflammatory effects, there’s no concrete evidence yet available that proves essential oils work to cure heel spurs.

It’s also important to keep in mind that these oils have medicinal properties. When used incorrectly, they can cause side effects. Always combine a few drops of an essential oil with at least three times the amount of a carrier oil and conduct a patch test prior to application..

Preventing heel spurs requires an increased attention to your overall foot health. Be mindful of the everyday stresses you place on your feet. Be sure to give them a rest at the end of the day.

As a rule of thumb, you should never push through any heel pain that develops.

Continuing to walk, exercise, or wear shoes that cause heel pain can lead to long-term issues such as heel spurs. If you experience heel pain after any activity, ice the area and give your foot a rest until it gets better.

Pain in the heel – causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment

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Heel pain: causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Definition

Pain in the heel region not only causes discomfort, but also deprives a person of the opportunity to stand for a long time and move normally. Pain usually results from inflammatory changes in the tissues surrounding the heel bone and is often long-lasting and recurrent. The calcaneus is the largest of all the bones in the foot and bears the greatest stress when walking.

Types of heel pain

Depending on the disease that is accompanied by pain in the heel, the nature of the pain syndrome will vary. Possible acute pain that occurs when walking and standing. Pain may appear in the morning when a person gets up after sleep, then it decreases or disappears completely. In other cases, heel pain is aching in nature and is not associated with a load on the leg. With a number of diseases, pain bothers not only when walking, but also at night, at rest. Sometimes, along with pain, numbness, tingling and “goosebumps” are felt, the skin may turn red, swelling appears.

The pain may worsen with foot extension and in some cases causes limitation of mobility in the ankle joint.

Possible causes of heel pain

The causes of heel pain can be divided into physiological and pathological. The first includes foot strain due to wearing uncomfortable shoes or shoes with a flat sole and no arch support, due to standing for a long time, due to increased stress on the foot during pregnancy or during rapid weight gain.

Pathological causes are various diseases and injuries.

Achilles tendinitis and plantar fasciitis (heel spur) . During physical exertion and overstretching of the tendons attached to the calcaneus, their inflammation occurs, which is manifested by pain in the heel and in the tendon area during physical exertion, local swelling on the back of the heel, and a feeling of weakness in the ankle joint. Flexion and extension of the foot is painful. Tendinitis of the Achilles tendon (Achilledynia) is often the result of spondyloarthritis (disease of the intervertebral discs), hypermobility of the joints (hereditary disease or predisposition), flat feet, shortening of one of the lower extremities due to a pelvic tilt due to intervertebral hernias.

Plantar fasciitis, or heel spur, is also characterized by inflammation of the plantar ligaments. The consequence of this process is the formation of a heel spur, that is, marginal bone growths (osteophytes). Patients report pain when walking and standing along the entire plantar surface of the foot.

Most often, pain makes itself felt at the first steps after a night’s sleep or prolonged sitting.

Tarsal tunnel syndrome is characterized by damage to the fibers of the tibial nerve due to its compression between the ligaments of the ankle in injuries, bone growths and soft tissue tumors. The syndrome is accompanied by burning pain and tingling in the heel area, and sometimes the entire sole. The pain worsens when the foot is extended. There may be a change in the sensitivity of the skin in the area of ​​​​the sole. In tarsal tunnel syndrome, foot function and gait are often impaired.

Traumatic injuries of the calcaneus (contusion, crack, fracture) . A calcaneal injury is more likely to occur when falling or jumping from a height in an upright position. A strong blow leads to a bruise or violation of the integrity of the bone (often combined with fractures of other bones of the lower extremities) and causes sharp pain, the inability to support the heel, and swelling that covers the foot and lower leg.

Damage to the calcaneus is rarely accompanied by an external violation of the integrity of the soft tissues; hematomas are more often noted on the lateral surfaces of the foot.

Achilles bursitis – the disease is characterized by inflammation of the synovial bursa, which is located between the calcaneal tendon and the calcaneal bone, and manifests itself as pain below and behind the heel, at the point of attachment of the Achilles tendon to the calcaneal tuberosity, redness and swelling in the area of ​​the calcaneal tuberosity, as well as partial restriction foot mobility. The causes of Achilles bursitis can be traumatic injuries due to wearing tight shoes, excessive physical exertion on the ankle joint, Haglund’s deformity. Less commonly, the disease is caused by metabolic and hormonal disorders, allergic reactions, autoimmune diseases, and infections.

Reactive arthritis – arthritis of the joints of which the calcaneus is a part (the articulation of the calcaneus with the tarsal bones – talus and navicular).

The disease develops as a result of infectious diseases (most often urogenital).

Pain syndrome appears two weeks later – a month after the infection. Severe pain is felt not only during exercise, but also at rest. Both heels may be affected, swelling and redness are noted.

Infectious diseases (tuberculosis, gonococcal infection, osteomyelitis of the calcaneus) is a fairly rare cause of heel pain. Mycobacterium tuberculosis and gonococci can develop in spongy bones and epiphyses of tubular bones, which leads to their local destruction. The process is accompanied by pain, swelling in the ankle joint and redness. The mobility of the foot is impaired.

Haglund’s deformity – ossification of the calcaneus, in which there is an osteo-cartilaginous growth in the area of ​​the calcaneal tuber, accompanied by the appearance of a growth (osteophyte) in the area of ​​attachment of the Achilles tendon. Such a pathology can be caused by a high arch or flat-valgus deformity of the foot (a combination of flat feet and valgus deformity of the foot – deviation of the thumb towards the remaining fingers), a decrease in the elasticity of the tendons.

Valgus deformity of both feet

Constant friction of the Achilles tendon leads to the development of an inflammatory process and changes in the cartilage, sometimes with the formation of sharp spikes. Patients may notice a hard protrusion on the back of the heel. The function of the foot, as a rule, is not disturbed, but inflammation of the joint capsule and tendon sheath leads to pain when walking, and sometimes at rest.

The disease is more common in young women due to wearing uncomfortable shoes with high heels.

Calcaneal epiphysitis – this disease develops in children aged 8-15 years due to a violation of the processes of ossification (ossification) of the calcaneus. Normally, the heel bone is formed as a result of the activity of two centers of ossification. One of them functions from the birth of a child, the other – from about 8 years old. Between the centers of ossification is cartilage tissue, which eventually transforms into bone. In case of cartilage overload between these two areas, cartilage degradation or partial rupture is possible, which is accompanied by inflammation and pain on the back and side of the heel, aggravated by the load. There is a limitation of the amplitude of movement, and with a rupture of the cartilage – swelling and redness.

Osteochondropathy of the apophysis of the calcaneal tuber, or Haglund-Schinz disease – the disease is characterized by aseptic (non-infectious) necrosis of the calcaneal tuber, which occurs due to injury, wearing uncomfortable shoes, due to hereditary predisposition and hormonal imbalance. Tendons attached to the tubercle during overstrain constantly injure the bone, which causes pain and swelling, which increase after the load and when the foot is extended. A swelling can be seen above the heel tubercle. It is noted that Haglund-Shinz disease is more common in girls aged 12-16 years.

To reduce the severity of pain, patients lean on their toes when walking.

Pain in the heel can be caused by dermatological and vascular pathologies that are diagnosed in patients with diabetes mellitus (trophic ulcers in diabetic foot syndrome), with varicose veins, and thrombophlebitis. Patients experience a slight pulling, pulling pain, fatigue. There are swelling of the feet, intermittent lameness.

Doctors to contact for heel pain

In case of heel pain, especially in case of injury, it is recommended to consult an orthopedic traumatologist. In some cases, consultation with an infectious disease specialist and other specialists is required to determine the diseases that caused the onset of pain.

Diagnosis and examination of heel pain

When heel pain occurs, a careful history taking and instrumental investigations are necessary. First of all, a clinical blood test is prescribed, as well as tests for infectious diseases – chlamydial and gonococcal infections, tuberculosis.

Clinical blood test: general analysis, leukoformula, ESR (with microscopy of a blood smear in the presence of pathological changes)

Synonyms: Complete blood count, UAC. Full blood count, FBC, Complete blood count (CBC) with differential white blood cell count (CBC with diff), Hemogram.
Brief description of the study CBC: general a…

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Anti-Chlamydia tr.-IgA

Secretory antibodies that appear 1 to 2 weeks after infection and protect the mucous membranes from deeper penetration of chlamydia. Sharp marker

Up to 2 working days

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Gonococcus, determination of DNA (Neisseria gonorrhoeae, DNA) in synovial fluid

Determination of DNA of the causative agent of gonorrhea (Neisseria gonorrhoeae) in synovial fluid by polymerase chain reaction (PCR) with real-time detection. ..

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RUB 560

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Mycobacterium tuberculosis, detection of DNA (Mycobacterium tuberculosis, DNA) in synovial fluid

Determination of DNA of causative agents of tuberculosis, mycobacteria complex: M. tuberculosis, M. bovis, M. bovis BCG, M. microti, M. africanum in synovial fluid by polymerase chain reaction…

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RUB 570

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Imaging includes radiography of the ankle and calcaneus in two standard views.

X-ray of the bones of the foot

X-ray examination of the foot in two projections allows diagnosing injuries and other pathological changes, including flat feet.

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In some cases, computed tomography and ultrasound of the foot may be needed. With tunnel syndromes, the diagnosis is clarified according to electromyography. Magnetic resonance imaging allows you to assess the state of soft tissue structures.

How to deal with heel pain

It is important to limit the load on the foot as much as possible and choose shoes with a low stable heel.

Orthopedic arch support insoles help reduce the load on the heel bone, before buying which it is advisable to consult with a specialist in an orthopedic salon.

Heel pain treatment

In most cases, conservative therapy is sufficient. In inflammatory processes, non-steroidal anti-inflammatory drugs are prescribed, in infectious diseases – antibiotics. Trophic ulcers are treated with antiplatelet agents and phlebotonics, and in diabetes mellitus, correction of antidiabetic therapy is required.

Surgical intervention is necessary for torn ligaments, fractures, abscesses. Rarely, operations are performed for arthrosis of the tarsal joints, Haglund’s deformity, Schinz’s disease. Rehabilitation after surgery includes exercise therapy and physiotherapy.

Sources:

1. Clinical guidelines for the diagnosis and surgical treatment of injuries and diseases of the peripheral nervous system // Association of Neurosurgeons of Russia. – Moscow, 2015.
2. Traumatology. Clinical guidelines / Ed. S.P. Mironov. – GEOTAR-Media, 2018.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

methods of treatment, diagnosis and causes

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Heel pain – discomfort a wide range in multiple pathological processes of the calcaneus or surrounding soft tissues. Almost every person is familiar with heel pain in the morning, pain when stepping on, standing or walking. The nature of the pain is diverse: aching, stabbing, arching, and others. Depends on the disease and the degree of its progression. Repeatedly recurring pain in the heel, regardless of their severity, is an indication for an indispensable visit to a specialist doctor. The causes of discomfort are established on the basis of a survey, visual examination and according to hardware diagnostic methods. Let’s take painkillers analgesics until an accurate diagnosis is established, as well as temporary unloading of the foot.

Anatomical structure of the heel

The heel consists of bones, ligaments, tissues, which can cause pain in various lesions. Among them:

• skin and subcutaneous structures – react with pain to gout, sprain, spur and diabetic angiopathy;
• calcaneus – sore with arthritis, osteomyelitis, tuberculosis or fractures;
• bursae – affected by bursitis;
• ligaments, fascia – vulnerable to bruises, sprains, react to the “heel spur”;
• Achilles tendon – inflamed;
• vessels, nerves – hurt with any pathologies, bruises, tuberculosis and others;
• intertarsal joints – affected by gout.

Causes of heel pain on foot

The most common physiological causes of heel pain. Among them:

• wearing uncomfortable shoes, narrow, tight, with high heels. The foot is overloaded, as well as the entire musculoskeletal system;
• prolonged static or physical activity on the legs;
• a sharp increase in the load on the foot due to weight gain, pregnancy, heavy physical exertion.

In the early stages, the appearance of soreness can be relieved by a long rest. The development of pathology is accompanied by swelling, heaviness in the legs, circulatory disorders, leading to the development of concomitant diseases.

Pain in the heel due to injuries

• Fracture of the calcaneus. Occurs when falling or jumping from a significant height. The pain is sharp, sudden. Swelling increases in the damaged area and the intensity of pain increases. The heel increases its size, turns blue, palpation is painful, may be accompanied by a crackling sound;
• Bruise. Characteristic for children jumping in the process of playing. The pain has a pulling character, localized along the surface of the foot. Edema is moderately insignificant. When the limb is given rest, the pain subsides;
• Achilles tendon rupture. It is typical for athletes who violated the warm-up technology or gave a sharp load to the leg. It is determined by a sharp pain in the back of the leg, combined with a sharp crack of a rupture. Movement of the heel is impossible, the pain is severe, but tolerable in a state of immobility;
• Fracture in osteoporosis. Age-related injury with reduced strength of bone tissue. Pain is moderate to intense. Edema of moderate severity, may be absent;
• Ankle ligament injury. Accompanied by severe pain and increasing swelling.

Tendon and ligament inflammation pain

• Achilles tendonitis. Consequence of overload. Soreness can increase for several months, periodically accompanied by swelling, painful palpation and fever of the affected area;
• Haglund’s deformity. Pressing pains on the back of the heel while walking. A dense painful bump is revealed;
• Heel spur. The pain is pronounced, most acute at the beginning of the movement, walking is disturbed, the gait changes. During periods of exacerbation, movement is impossible even with support;
• Disease of the North. Typical for teenage boys. Aching pain aggravated by movement. External changes are not detected.

Heel pain in diseases of the joints

Arthritis also causes pain in the heel area. Starting pains are pulling in nature, discomfort increases with time, aggravated by the weather, at night, during exercise. Are fraught with deformation of the limbs and limited mobility.

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Pain associated with infection

• Hematogenous osteomyelitis. The result of the introduction of infection from another focus. More often found in children. It is characterized by a rise in temperature, general intoxication of the body, bursting pain;
• Post-traumatic osteomyelitis. The pain is intense, tearing, a sharp wound discharges a large amount of pus, and fistulas may also form.

Dermatological problems characterized by pain in the heel

• Callus. Corn abscess can give painful symptoms with the formation of an abscess. Opening the pathological focus facilitates the condition, reducing the severity of pain;
• Wart. A protruding plantar wart gives pain with constant injury, after a long walk;
• Hyperkeratosis of the feet. Leads to the formation of cracks, calluses, bruising. The pains are burning and jerking;
• Trophic ulcers. Specific manifestation of diabetes mellitus, severe varicose veins, thrombophlebitis. The pain syndrome is moderate.

Diagnosis of the disease

Proper diagnosis and differentiation from diseases with similar symptoms is essential for the successful treatment of heel pain. The complex of studies is carried out by therapists, traumatologists, surgeons, neurologists and other specialists. Possible diagnostic procedures are very diverse.

Treatment of heel pain

If the cause of pain is an injury, immobilize the foot, apply cold, and take pain medication. Then the victim is taken to the emergency room and transferred to the hands of specialists. The necessary treatment is being carried out.

The inflammatory process in the heel area is stopped by limiting or completely eliminating any load, applying local anesthetics or anti-inflammatory drugs. It is not necessary to relieve a sharp pain with medication, it is recommended to contact a medical institution. The same procedure is necessary in case of deterioration of the patient’s well-being, signs of suppuration, and an increase in body temperature.

Treatment can be carried out:

• Conservative methods. They include a mode of carefully reducing the load on the painful area until complete recovery, wearing special orthopedic shoes, heel pads, a plaster cast or splint, moving with a cane or crutch. Additionally, drug therapy prescribed by a doctor is used. NSAIDs, antibiotics, phlebotonics and other drugs are appropriate. In the case of concomitant diseases, the entire range of medications used by the patient is adjusted to obtain the optimal result. The feet are regularly treated, the affected area is bandaged. In most unburdened cases, specialized physiotherapy exercises and physiotherapy are indicated;
• Surgical methods. Surgical intervention is chosen by the attending physician, taking into account the nature of the existing pathology: trauma, infection, trophic ulcers, and others. The postoperative period for any possible disease is characterized by a long and complex rehabilitation, which is the process of developing a limb with the help of physical education and physiotherapy.

Pain in the heel when walking: effective treatment in Moscow

The specialists of our clinic have been successfully dealing with the problem of heel pain for many years, diagnosing the diseases that caused painful symptoms, and achieving stable positive results in the cure. Doctors widely use an integrated approach that includes time-tested classical methods of therapy, as well as the latest achievements of modern medicine. The professional arsenal of experienced specialists includes a huge number of rehabilitation programs and methods. The doctors of the clinic regularly undergo education and training in the best medical centers in Israel, the USA, Germany, get acquainted with the achievements of innovative therapy and surgery. Each patient can attend a free appointment and have our specialists diagnose their problem. Therapeutic sessions guarantee a quick improvement in well-being, removal of pain manifestations in 1-2 visits.

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Frequently asked questions

Can heel pain go untreated?

Ignoring this serious symptom is not recommended. The disease can progress rapidly, causing severe pain. In the most critical cases, surgery will be required. Under the external symptoms of arthritis, benign or malignant neoplasms can be masked, for which timeliness is a guarantee of successful treatment.

Which doctor should I consult for heel pain?

Make an appointment with a general specialist or orthopedic traumatologist. At the first stage, a comprehensive diagnosis will be carried out and the exact cause of the painful manifestations will be established. After that, the patient will be referred to a specialist in the desired profile.

How common is heel pain?

Complaint of pain in the heels when visiting an orthopedist-traumatologist is one of the most common symptoms of various diseases. Athletes, people with overweight, representatives of professions who are forced to spend a long time on their feet and many others suffer from it. At risk are patients with diabetes, as well as men over 35 years of age.

What is a heel spur?

The common name “calcaneal spur” is firmly attached to plantar fasciitis, an inflammatory disease of the connective tissue in the sole of the foot. The disease is associated with a high load on the fascia and its microtrauma. The dying cells of the tissue are rich in calcium, which forms a painful bone formation, shaped like a spur.

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Marshenin Konstantin Vladimirovich

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