What are the common causes of heel pain. How can heel pain be treated effectively at home. When should you seek medical attention for heel pain. What are the professional treatment options for persistent heel pain. How can heel pain be prevented in daily life.

Understanding the Anatomy of the Heel

The foot and ankle are complex structures, comprising 26 bones, 33 joints, and over 100 tendons. At the center of this intricate system lies the heel, which is the largest bone in the foot. This essential component of our anatomy bears significant weight and stress during daily activities, making it susceptible to various forms of pain and discomfort.

Given its crucial role in mobility, heel pain can range from a mild inconvenience to a debilitating condition that significantly impacts one’s quality of life. Understanding the underlying causes and available treatment options is vital for anyone experiencing heel discomfort.

Common Causes of Heel Pain

Heel pain can stem from a variety of sources, each with its unique characteristics and treatment requirements. Here are some of the most prevalent causes:

Plantar Fasciitis

Plantar fasciitis is one of the most common culprits behind heel pain. It occurs when the plantar fascia ligament, which runs along the bottom of the foot, becomes inflamed due to excessive pressure or strain. This condition typically causes a sharp, stabbing pain in the heel, especially during the first steps in the morning or after periods of rest.

Sprains and Strains

Heel pain can also result from sprains and strains, which are injuries to the soft tissues of the foot. These often occur during physical activities or as a result of accidents. The severity can range from minor discomfort to significant pain that impairs walking.

Fractures

In more severe cases, heel pain may be caused by a fracture in the heel bone. This is typically the result of high-impact injuries or falls. Fractures are considered medical emergencies and require immediate attention.

Achilles Tendonitis

Achilles tendonitis is an overuse injury affecting the tendon that connects the calf muscles to the heel bone. It often results in pain and stiffness at the back of the heel, particularly during and after physical activity.

Bursitis

Bursitis occurs when the small, fluid-filled sacs (bursae) that cushion the bones, tendons, and muscles near joints become inflamed. In the heel, this can lead to pain and swelling, especially with prolonged standing or walking.

Ankylosing Spondylitis

While primarily affecting the spine, ankylosing spondylitis can also cause inflammation in other parts of the body, including the heel. This chronic condition can lead to persistent heel pain as part of its systemic effects.

Osteochondroses

These disorders affect bone growth in children and adolescents. Sever’s disease, a type of osteochondrosis affecting the heel, is a common cause of heel pain in physically active children.

Reactive Arthritis

Reactive arthritis is triggered by an infection elsewhere in the body and can cause inflammation in various joints, including those in the heel. This can result in pain, swelling, and stiffness in the affected area.

Home Remedies for Heel Pain Relief

For many individuals experiencing heel pain, initial treatment can begin at home. Here are some effective self-care strategies:

• Rest: Giving your heel adequate time to recover is crucial. Avoid activities that exacerbate the pain and consider using crutches or a cane if necessary.
• Ice Therapy: Apply ice to the affected area for 10 to 15 minutes, twice daily. This can help reduce inflammation and numb the pain.
• Over-the-counter Pain Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and reduce inflammation.
• Supportive Footwear: Wear shoes that provide good arch support and cushioning. Avoid going barefoot, especially on hard surfaces.
• Stretching Exercises: Gentle stretches for the calf muscles and plantar fascia can help alleviate tension and improve flexibility.

While these home remedies can be effective for mild cases, persistent or severe heel pain may require professional medical attention.

When to Seek Medical Attention

Knowing when to consult a healthcare professional is crucial for proper diagnosis and treatment of heel pain. You should make an appointment with your doctor if:

• Your heel pain doesn’t improve after two to three weeks of home treatment
• The pain is severe or suddenly worsens
• You experience redness or swelling in your heel
• You’re unable to walk comfortably due to the pain
• You have a fever accompanying the heel pain
• You have diabetes and are experiencing heel pain

Prompt medical attention is particularly important if you’ve experienced a sudden, severe pain following an injury, as this could indicate a fracture or other serious condition requiring immediate treatment.

Professional Treatment Options for Heel Pain

When home remedies prove insufficient, a variety of professional treatments are available to address heel pain. The specific approach will depend on the underlying cause and severity of the condition.

Physical Therapy

A physical therapist can design a customized program of exercises to stretch and strengthen the muscles and tendons in your foot and lower leg. This can help alleviate pain and prevent future issues.

Orthotic Devices

Custom-made orthotics or over-the-counter arch supports can help distribute pressure more evenly across your foot, reducing strain on the heel.

Corticosteroid Injections

For severe inflammation, a doctor may recommend corticosteroid injections to provide rapid pain relief. However, these are typically used sparingly due to potential side effects.

Extracorporeal Shock Wave Therapy (ESWT)

This non-invasive treatment uses sound waves to stimulate healing in the affected area. It’s often considered for chronic cases that haven’t responded to other treatments.

Night Splints

These devices keep the plantar fascia stretched overnight, potentially reducing morning pain and stiffness.

Surgery

In rare cases where conservative treatments fail to provide relief, surgery may be considered. This could involve releasing the plantar fascia, removing a bone spur, or addressing other structural issues.

Preventing Heel Pain: Proactive Measures

While not all cases of heel pain are preventable, there are several steps you can take to reduce your risk:

• Maintain a healthy weight to reduce stress on your feet
• Wear shoes that fit well and provide adequate support
• Replace athletic shoes regularly, especially if you’re a runner
• Warm up properly before exercise and sports activities
• Gradually increase the intensity and duration of your workouts
• Stretch your feet, ankles, and calves regularly
• Avoid walking barefoot on hard surfaces
• Use shock-absorbing insoles if you stand for long periods

By incorporating these preventive measures into your daily routine, you can significantly reduce your risk of developing heel pain and maintain optimal foot health.

The Impact of Lifestyle on Heel Health

Your daily habits and lifestyle choices can have a significant impact on the health of your heels and overall foot condition. Understanding these factors can help you make informed decisions to protect your feet from pain and injury.

Occupation and Heel Health

Certain occupations that require long periods of standing or walking on hard surfaces can increase the risk of heel pain. If your job falls into this category, consider these strategies:

• Use anti-fatigue mats if you stand in one place for extended periods
• Take regular breaks to sit down and elevate your feet
• Alternate between different pairs of supportive shoes throughout the week
• Perform foot and ankle exercises during breaks to improve circulation and flexibility

The Role of Exercise in Heel Pain Prevention

Regular exercise is crucial for overall health, but certain activities can put extra stress on your heels. To minimize the risk of heel pain while staying active:

• Choose low-impact activities like swimming or cycling if you’re prone to heel pain
• Gradually increase the intensity and duration of your workouts to allow your feet to adapt
• Incorporate strength training exercises for your feet and ankles into your routine
• Always wear appropriate footwear for your chosen activity

Nutrition and Foot Health

Your diet can also play a role in maintaining healthy feet and preventing heel pain. Consider these nutritional tips:

• Ensure adequate calcium and vitamin D intake for strong bones
• Consume foods rich in omega-3 fatty acids to help reduce inflammation
• Stay hydrated to maintain the elasticity of your connective tissues
• Maintain a balanced diet to support overall foot health and prevent conditions like gout that can affect the feet

Advanced Diagnostic Techniques for Heel Pain

When the cause of heel pain isn’t immediately apparent, healthcare providers may employ various diagnostic techniques to pinpoint the issue. Understanding these methods can help you prepare for potential medical appointments:

Imaging Studies

Different imaging techniques can provide valuable insights into the structures of your foot:

• X-rays: Can reveal bone spurs, fractures, or other bone abnormalities
• MRI (Magnetic Resonance Imaging): Provides detailed images of soft tissues, helpful for diagnosing conditions like plantar fasciitis
• Ultrasound: Can visualize soft tissue structures and inflammation in real-time
• CT (Computed Tomography) Scan: Offers detailed cross-sectional images of the foot, useful for complex cases

Gait Analysis

A gait analysis involves observing how you walk or run. This can reveal biomechanical issues that may be contributing to your heel pain. It often involves:

• Visual observation by a trained professional
• Use of treadmills with slow-motion video capture
• Pressure plate analysis to measure how you distribute weight across your feet

Blood Tests

In some cases, blood tests may be ordered to rule out systemic conditions that can cause heel pain, such as:

• Rheumatoid arthritis
• Gout
• Infections

Emerging Treatments for Chronic Heel Pain

For individuals with persistent heel pain that doesn’t respond to conventional treatments, several innovative therapies are emerging:

Platelet-Rich Plasma (PRP) Therapy

This treatment involves injecting a concentration of the patient’s own platelets into the affected area to promote healing. While still considered experimental for heel pain, some studies have shown promising results.

Stem Cell Therapy

Similar to PRP, stem cell therapy aims to promote tissue repair and regeneration. It’s still in the early stages of research for heel pain but shows potential for future treatment options.

Cryoablation

This minimally invasive procedure uses extremely cold temperatures to temporarily disable nerves causing pain. It’s being explored as an option for chronic plantar fasciitis.

Radiofrequency Ablation

This technique uses heat from radio waves to interrupt pain signals from specific nerves. It’s being investigated as a potential treatment for recalcitrant heel pain.

While these treatments show promise, it’s important to note that they are still being studied and may not be widely available or covered by insurance. Always consult with a qualified healthcare provider to determine the most appropriate treatment plan for your specific condition.

The Psychological Impact of Chronic Heel Pain

Chronic heel pain can have significant effects beyond physical discomfort. The psychological impact of persistent pain can be profound and should not be overlooked in the treatment process.

Mental Health Considerations

Living with chronic heel pain can lead to various mental health challenges:

• Depression: Persistent pain and limited mobility can contribute to feelings of sadness and hopelessness
• Anxiety: Worries about pain worsening or interfering with daily activities can cause anxiety
• Sleep disturbances: Pain can make it difficult to get restful sleep, further impacting mental health
• Social isolation: Reduced ability to participate in social activities can lead to feelings of loneliness

Coping Strategies

Developing effective coping mechanisms is crucial for managing the psychological impact of chronic heel pain:

• Mindfulness and meditation techniques to manage pain perception
• Cognitive-behavioral therapy to address negative thought patterns
• Joining support groups to connect with others experiencing similar challenges
• Engaging in enjoyable activities that don’t exacerbate the pain
• Setting realistic goals and celebrating small achievements in pain management

Addressing both the physical and psychological aspects of chronic heel pain is essential for comprehensive treatment and improved quality of life. Healthcare providers should consider a multidisciplinary approach that includes mental health support when developing treatment plans for patients with persistent 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

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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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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.

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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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