What causes sharp shooting pain in the heel. How can plantar fasciitis be diagnosed and treated. What are the risk factors for developing heel pain. How can physical therapy help alleviate heel discomfort. When should you seek medical attention for persistent heel pain.

Understanding Plantar Fasciitis: The Primary Culprit of Heel Pain

Plantar fasciitis is a common condition affecting approximately two million Americans, making it one of the leading causes of heel pain. This condition occurs when the plantar fascia, a ligament extending from the heel to the toes along the foot’s bottom, becomes inflamed and swollen. The result is a sharp, stabbing pain in the heel, particularly noticeable during the first few steps in the morning or after periods of rest.

While plantar fasciitis can affect both sedentary individuals and athletes, it’s particularly common among the latter group. The condition typically stems from chronic overload due to lifestyle factors or exercise habits, such as prolonged standing or running.

Symptoms of Plantar Fasciitis

• Sharp, stabbing pain in the heel, especially in the morning
• Pain that improves with movement but worsens after long periods of weight-bearing
• Discomfort that may increase after exercise or prolonged activity
• Tenderness in the arch of the foot

Risk Factors Contributing to Sharp Heel Pain

Several factors can increase the likelihood of developing plantar fasciitis and experiencing sharp heel pain. Understanding these risk factors can help individuals take preventive measures and seek appropriate treatment when necessary.

Common Risk Factors for Plantar Fasciitis

• Obesity
• Flat feet (pes planus) or high-arched feet (pes cavus)
• Shortened Achilles tendon
• Overpronation (inward rolling of the foot)
• Limited ankle dorsiflexion
• Weak intrinsic foot muscles or plantar flexor muscles
• Poor biomechanics or alignment
• Deconditioning
• Walking on hard surfaces or barefoot
• Prolonged weight-bearing activities
• Inadequate stretching
• Wearing inappropriate footwear

Home Remedies for Alleviating Sharp Heel Pain

For those experiencing acute heel pain, several self-management techniques can be employed at home to provide relief. These methods can help reduce discomfort and improve mobility, especially during the initial stages of plantar fasciitis.

Effective Home Treatments

1. Calf and arch stretches: Keep a towel by your bedside and perform stretches before sleeping and upon waking. Pull back on your foot for 30 seconds, repeating three times with 30-second rest intervals.
2. Foot flexing exercises: Flex your feet towards and away from your knees to loosen the feet and reduce pain during the first few steps.
3. Plantar fascia rolling: Use a lacrosse ball to roll out the plantar fascia before bed and in the morning. Roll for about one minute, three times, with 30-second rest periods.

The Role of Physical Therapy in Treating Plantar Fasciitis

When home remedies fail to provide sufficient relief, physical therapy can be an effective next step in treating plantar fasciitis. A professional physical therapist can develop a tailored treatment plan based on the root cause of your heel pain.

Can physical therapy effectively treat plantar fasciitis?

Yes, physical therapy can be highly effective in treating plantar fasciitis. A comprehensive treatment plan may include manual therapy, targeted exercises, ice therapy, and taping techniques. These interventions aim to reduce pain, improve flexibility, and strengthen the affected area, promoting faster healing and preventing chronic pain development.

Common Physical Therapy Interventions

• Manual therapy techniques to improve tissue mobility
• Customized exercise programs to strengthen foot and lower leg muscles
• Ice therapy to reduce inflammation
• Taping methods to support the plantar fascia
• Gait analysis and correction of biomechanical issues
• Education on proper footwear and activity modifications

Other Common Causes of Heel Pain

While plantar fasciitis is the most frequent cause of heel pain, several other conditions can lead to discomfort in this area. Understanding these alternative causes can help in obtaining an accurate diagnosis and appropriate treatment.

What are some other conditions that can cause heel pain?

Besides plantar fasciitis, heel pain can be caused by conditions such as:

• Achilles tendinitis
• Heel spurs
• Bursitis
• Stress fractures
• Tarsal tunnel syndrome

Each of these conditions has unique characteristics and may require different treatment approaches. It’s essential to consult with a healthcare professional for an accurate diagnosis and tailored treatment plan.

When to Seek Medical Attention for Heel Pain

While many cases of heel pain can be managed with home remedies and self-care, certain situations warrant professional medical attention. Recognizing these signs can help prevent the development of chronic conditions and ensure timely treatment.

When should you consult a doctor about heel pain?

It’s advisable to seek medical attention if you experience:

• Severe pain or swelling in the heel
• Inability to bend your foot downward or stand on your toes
• Heel pain accompanied by fever, numbness, or tingling
• Severe pain following an injury
• Pain that persists beyond a few weeks despite home treatment

Early intervention can significantly improve treatment outcomes and prevent the development of chronic conditions that are more challenging to treat.

Preventive Measures to Avoid Sharp Heel Pain

Taking proactive steps to maintain foot health can significantly reduce the risk of developing plantar fasciitis and other causes of heel pain. Implementing these preventive measures can help keep your feet healthy and pain-free.

How can you prevent sharp heel pain?

To minimize the risk of developing heel pain, consider the following strategies:

• Maintain a healthy weight to reduce stress on your feet
• Wear supportive, well-fitting shoes appropriate for your activities
• Gradually increase the intensity and duration of your exercise routines
• Stretch your calves and plantar fascia regularly, especially before and after exercise
• Avoid going barefoot on hard surfaces for extended periods
• Replace athletic shoes regularly, especially if you’re a runner
• Use orthotic inserts if you have flat feet or high arches
• Cross-train with low-impact activities to reduce stress on your feet

By incorporating these preventive measures into your daily routine, you can significantly reduce the likelihood of experiencing sharp heel pain and maintain optimal foot health.

The Impact of Footwear on Heel Health

The shoes we wear play a crucial role in foot health and can significantly influence the development or prevention of heel pain. Choosing appropriate footwear is essential for maintaining proper foot alignment and reducing stress on the plantar fascia.

How does footwear affect heel pain?

Footwear can impact heel pain in several ways:

• Insufficient arch support can lead to overpronation and increased strain on the plantar fascia
• Shoes with inadequate cushioning fail to absorb shock, transferring more stress to the heel
• High heels can shorten the Achilles tendon and increase pressure on the heel
• Worn-out shoes lack the necessary support and stability for proper foot function

Characteristics of Foot-Friendly Shoes

When selecting shoes to prevent or alleviate heel pain, look for the following features:

• Adequate arch support tailored to your foot type
• Sufficient cushioning in the heel area
• A firm, supportive heel counter
• Flexibility in the ball of the foot
• A wide toe box to allow natural toe spreading
• Breathable materials to reduce moisture buildup

Investing in high-quality, supportive footwear can significantly contribute to preventing and managing heel pain, promoting overall foot health.

The Role of Orthotics in Managing Heel Pain

Orthotics, both over-the-counter and custom-made, can play a significant role in managing and preventing heel pain. These devices provide additional support and help correct biomechanical issues that may contribute to plantar fasciitis and other heel conditions.

Can orthotics help with heel pain?

Yes, orthotics can be highly beneficial in managing heel pain. They work by:

• Providing additional arch support to distribute pressure more evenly across the foot
• Correcting overpronation or supination to improve foot alignment
• Offering extra cushioning to absorb shock and reduce stress on the heel
• Supporting the plantar fascia to reduce strain and promote healing

Types of Orthotics for Heel Pain

There are several types of orthotics available for managing heel pain:

1. Over-the-counter insoles: These provide general support and cushioning and can be helpful for mild cases of heel pain.
2. Heat-moldable inserts: These can be customized to some extent by heating and molding them to your foot shape.
3. Custom orthotics: Prescribed by a podiatrist or orthopedic specialist, these are tailored to your specific foot structure and condition.
4. Heel cups: These small, cup-shaped inserts provide targeted cushioning and support for the heel area.

While over-the-counter options can be effective for many people, those with severe or persistent heel pain may benefit from custom orthotics designed to address their specific needs.

The Connection Between Body Weight and Heel Pain

Body weight plays a significant role in the development and persistence of heel pain, particularly plantar fasciitis. Understanding this connection can motivate individuals to maintain a healthy weight as part of their overall foot health strategy.

How does excess weight contribute to heel pain?

Excess body weight can impact heel health in several ways:

• Increased pressure: Extra weight puts more stress on the plantar fascia with each step.
• Altered biomechanics: Weight gain can change how you walk, potentially leading to overpronation.
• Reduced shock absorption: Excess weight compresses the fat pad in the heel, diminishing its natural shock-absorbing ability.
• Inflammation: Obesity is associated with increased inflammation throughout the body, which can exacerbate heel pain.

Benefits of Weight Management for Heel Health

Maintaining a healthy weight or losing excess weight can significantly improve heel pain by:

• Reducing stress on the plantar fascia and other foot structures
• Improving overall foot biomechanics
• Decreasing systemic inflammation
• Enhancing the effectiveness of other treatments for heel pain

For individuals struggling with persistent heel pain and carrying excess weight, a comprehensive approach that includes weight management strategies alongside targeted foot treatments may yield the best results.

The Importance of Proper Stretching and Exercise

Regular stretching and targeted exercises play a crucial role in preventing and managing heel pain. These activities help improve flexibility, strengthen supporting muscles, and promote proper foot mechanics.

How can stretching and exercise help alleviate heel pain?

Stretching and exercise can benefit heel health by:

• Increasing flexibility of the plantar fascia and Achilles tendon
• Strengthening the muscles that support the arch of the foot
• Improving overall foot and ankle stability
• Enhancing blood flow to the affected area, promoting healing
• Reducing the risk of future injuries

Effective Stretches and Exercises for Heel Pain

Consider incorporating these stretches and exercises into your routine:

1. Plantar fascia stretch: Roll your foot over a tennis ball or frozen water bottle.
2. Calf stretches: Lean against a wall with one leg behind, keeping the back leg straight.
3. Towel curls: Scrunch a towel on the floor with your toes.
4. Heel raises: Stand on the edge of a step and slowly raise and lower your heels.
5. Arch lifts: While seated, try to lift the arch of your foot without curling your toes.

Remember to start gently and gradually increase the intensity and duration of these exercises. If you experience pain during any exercise, stop immediately and consult a healthcare professional.

Long-Term Management and Prognosis of Heel Pain

While acute heel pain can be distressing, understanding the long-term outlook and management strategies can provide reassurance and guide treatment decisions. Most cases of heel pain, including plantar fasciitis, can be successfully managed with appropriate care and patience.

What is the long-term prognosis for heel pain?

The prognosis for heel pain is generally favorable. With proper treatment and management:

• Most cases of plantar fasciitis resolve within 6-18 months
• Many people experience significant improvement within weeks to months of starting treatment
• Recurrence is possible but can often be prevented with ongoing self-care and preventive measures
• Chronic cases may require more intensive or prolonged treatment but can still improve

Strategies for Long-Term Management

To maintain foot health and prevent recurrence of heel pain:

• Continue with regular stretching and strengthening exercises
• Maintain a healthy weight
• Wear supportive, well-fitting shoes appropriate for your activities
• Replace athletic shoes regularly
• Use orthotics if recommended by your healthcare provider
• Modify activities as needed to avoid overloading the plantar fascia
• Address any underlying biomechanical issues or health conditions

By adopting these long-term management strategies, individuals can significantly reduce the risk of recurring heel pain and maintain optimal foot health. Remember that consistency is key, and integrating these practices into your daily routine can lead to lasting benefits for your feet and overall well-being.

What Causes It and What Are Your Treatment Options

Are you experiencing heel pain in the morning? Do the first few steps out of bed cause you to cringe in pain? Discover common causes of a sharp pain in heel and what you can do about it.

What Causes Sharp Pain in the Heels?

Plantar fasciitis is one of the most common causes of heel pain. In fact, it has been estimated to affect about two million people in the US. Symptoms of this condition are caused by inflammation and swelling of the plantar fascia, a ligament that extends from your heel to your toes along the bottom of the foot. 

All this inflammation and swelling can lead to a feeling of sharp pain in the heel, usually in the morning or after a rest period. It tends to improve with movement, but can be aggravated by long periods of weight bearing. 

Although Plantar fasciitis is the most common heel injury in athletes, it can affect both sedentary and athletic individuals. Experts believe this heel pain results from chronic overload due to lifestyle or exercise, such as standing for long periods of time or running.

Risk Factors for Plantar Fasciitis / Sharp Heel Pain

Some common risk factors for plantar fasciitis involving sharp heel pain include:  

• Obesity
• Pes planus (flat feet)
• Pes cavus (high-arched feet)
• Shortened Achilles tendon
• Overpronation (inward roll)
• Limited ankle dorsiflexion
• Weak intrinsic muscles of the foot
• Weak plantar flexor muscles
• Poor biomechanics or alignment
• Deconditioning
• Hard surface
• Walking barefoot
• Prolonged weight bearing
• Inadequate stretching
• Poor footwear

Alleviating Sharp Pain in the Heel at Home

Self-management at home can be helpful. If you experience acute pain in the heel, consider keeping a towel near your bedside and performing a calf and arch stretch. Do this before going to sleep and before taking any steps out of bed in the morning. Pull back on your foot for about 30 seconds three times, with 30 seconds of rest in between each set. Also simply flexing your feet toward and away from your knees (knees either flexed, extended, or both) can help “loosen” the feet to decrease the severity of pain during those first few steps.

You can also roll the plantar fascia with a ball, such as a lacrosse ball. Keep it at your nightstand and roll out the plantar fascia before going to sleep and again before taking your first steps in the morning. Roll for about 1 minute, three times, with 30 seconds of rest in between.

How Physical Therapy Can Help Plantar Fasciitis

If home treatments for your heel pain don’t provide some relief, physical therapy can help. Treatment will depend on the root cause of your heel pain but may include:

• Manual therapy and exercise
• Ice
• Taping

If left untreated, plantar fasciitis may result in chronic pain and make it much more difficult to treat. With any injury the sooner a physical therapist is consulted, the sooner the painful impairments and related limitations will be controlled and quality of life improved.   To help in your recovery come to one of our physical therapy clinics to learn more about how our qualified physical therapists can help you find pain relief and walking normally once again. 

With 51 locations throughout New Jersey, we make it easy to find a physical therapy clinic near you. Simply search for your closest location using your zip code. The team at Twin Boro Physical Therapy looks forward to helping you get healthy and guiding you down the road to recovery. 

Why does my heel hurt? 5 top causes

Stabbing heel pain in the morning after a night’s rest. A reoccurring ache that comes on after activity and sticks around for a couple days. A new, painful bump on the back of your heel. Are your heels just sore? Or is something else causing your heel pain?

You use your feet a lot every day. So occasional aches and pains are pretty common. But if pain is coming and going, or sticking around for a bit, there may be something else going on. And the one thing all heel pain has in common is this: It’s a signal that your heel needs healing.

Read on to learn the top causes of heel pain and when to get help.

The most common cause of heel pain: Plantar fasciitis

Plantar fasciitis is caused by inflammation or damage to the plantar fascia, which is the ligament that runs along the bottom of your foot and attaches to your heel. This condition is usually caused by repetitive motion or anything that puts a lot pressure on the arch of your foot.

When and where does your heel hurt with plantar fasciitis?

Plantar fasciitis pain can flare up at any time. Sometimes you’ll get heel pain during or after exercise, or from being on your feet for a long time. If your heels hurt after walking or other exercise, you’ll likely feel a sharp stabbing pain in the arch of your foot or the bottom of your heel. This signals that the plantar fascia is inflamed or damaged from overuse, and probably needs some rest and care.

One of the most common signs of plantar fasciitis is heel pain after long periods of rest. In the morning, the muscles in your feet might feel tight while lying in bed. Then, when you put your foot on the ground, it’s the worst kind of shooting, stabbing pain. So why does this happen? Why is heel pain worse in the morning?

The way people rest their feet in bed causes the plantar fascia ligament to tighten during sleep. This is the same reason you’re likely to experience heel pain after sitting for a while. The good news is the rest is probably helping your foot heal. Once you get up and walk around a bit, the tissue will stretch out and feel better.

How is plantar fasciitis diagnosed and treated?

Plantar fasciitis can be officially diagnosed by a podiatrist, a doctor who specializes in foot and ankle conditions. Fortunately, there are at-home treatments for plantar fasciitis that are very effective for managing and healing pain. These include investing in more supportive footwear, rest, hot and cold therapy, and targeted stretches and exercises.

Another thing that can help? Avoiding bare feet, even at home. Going barefoot puts additional strain on your feet. So, slip on supportive slippers or shoes instead.

If your heel pain gets worse or begins to impact daily activities, a podiatrist may recommend a cortisone injection. In more serious cases, surgery can be an option if conservative treatments have lost their effectiveness.

Other common heel pain causes

Achilles tendonitis

If you’re consistently experiencing pain above your heel, or in the back of your ankle during and after activity, Achilles tendonitis may be the cause.

This condition happens when the Achilles tendon becomes inflamed, usually due to overuse or when there is a big increase of frequency or intensity of exercise. This condition is especially common in runners.

You’ll likely notice a mild ache that gets more intense with continued activity. For example, you may experience tenderness or stiffness after long periods of rest or after working out. However, the pain usually starts getting better with mild activity or stretching throughout the day.

Like with other overuse injuries, the best treatment for Achilles tendonitis is usually rest, and avoiding or modifying activities to reduce strain. But if you have small tears in your Achilles tendon, there’s a chance you may need surgery.

If you think you have Achilles tendonitis, a podiatrist can give you an official diagnosis. They can also recommend additional treatments such as physical therapy, or wraps, braces or splints to reduce strain and help the tendon heal.

Haglund’s deformity

People with Haglund’s deformity have a bony enlargement on the back of their heel. Haglund’s deformity is often called the “pump bump” because it can be very common for people who wear high heels. However, any shoes with a rigid back, including men’s dress shoes and ice skates, can irritate the back of the heel.

Beyond the painful bump, symptoms of Haglund’s deformity include:

• Pain in back of heel where your Achilles tendon attaches to your heel
• Swelling in the back of your heel
• Skin redness and inflammation on the back of your heel

One of the best things you can do to relieve any pain is to invest in supportive shoes that have soft backs. Taking over-the-counter anti-inflammatory medications and icing your heel can also help.

But it’s also a good idea to make an appointment with a podiatrist – especially since Haglund’s deformity can lead to another painful condition called bursitis.

Heel bursitis

Heel bursitis is another reason for pain in the back of your heel. Bursitis is inflammation of the bursa, which is a small sack of fluid that cushions and lubricates areas where the tissues rub against each other. You have bursae throughout your body, both in and on the joints that are at risk for rubbing and pressure. There are two types of heel bursitis, and they are related to the locations of specific fluid pockets.

• Subcalcaneal bursitis – The calcaneal bursa is located between the Achilles tendon and the skin at the back of the heel. Calcaneal bursitis is often linked to Haglund’s deformity and usually comes from wearing ill-fitting shoes that dig into the back of the heel. Women who wear high heels or athletes who wear shoes with the wrong fit are at most risk for this type of inflammation. You may have calcaneal bursitis if you notice pain, redness and swelling on your heel that make it hard to put on your shoes.
• Retrocalcaneal bursitis – The retrocalcaneal bursa is located between the heel bone and the Achilles tendon, just above where the Achilles tendon meets the heel bone. This type of bursitis happens after repeated irritation of the bursa and can be related to both Achilles tendonitis and Haglund’s deformity. It’s also common for those who have posterior calcaneal bone spurs, which may need to be surgically removed to get relief. You may have this type of bursitis if you have severe pain and swelling where the Achilles tendon joins the heel bone.

Bursitis treatments are similar to other heel conditions – rest, anti-inflammatory medications, and applying heat or ice packs. It’s also best to avoid activities that would make pain worse – like another round of tennis or slipping into uncomfortable shoes. If the pain doesn’t go away or if your heel is hot to the touch, talk to a podiatrist.

Heel fracture

It’s also possible to fracture the large bone of your heel called the calcaneus. Sometimes this happens suddenly, following a traumatic event. At other times, a heel fracture develops more slowly as a result of overuse.

Calcaneus fracture following a traumatic event

If you fracture your heel – for example, after a fall or jump from a great height or in a car accident – you’ll probably know it by the sudden pain you feel in your heel. To diagnose your condition, the doctor will do a physical examination and take X-rays to determine the severity of the problem, which will determine the type of treatment you need.

Heel fracture resulting from overuse

Stress fractures typically begin with a small hairline fissure in the bone, so pain can come on slowly.

Symptoms of a stress fracture can vary based on the location and the severity of the fracture. There’s a good chance you’ll experience heel pain when walking, but it may or may not go away while you’re resting. Pain may be more manageable in the morning and worse at night.

If you think you have a stress fracture in your heel, hold off on physical activity and try to limit the amount of weight you place on your heel. You’ll also want to make an appointment with a podiatrist. Without treatment, the pain will become more severe and possibly lead to a complete fracture.

The most

uncommon cause of heel pain: Plantar bone spurs

Long-term, repetitive straining of the ligaments that connect your heel to your toes can cause a bone spur to develop on your heel. And actually, these bony growths form as your foot tries to heal itself.

Plantar bone spurs are relatively common – about one in 10 people have one. But only 5% experience foot pain because of bone spurs. If you have heel pain, it’s more likely from another condition, like plantar fasciitis. Many people with plantar fasciitis have plantar bone spurs.

Getting help for heel pain is a step in the right direction

If your heel is hurting, it wants your attention. There are a lot of ways to treat heel pain at home, including rest, ice or heat therapy, exercises and stretches, and investing in supportive shoes. But if your pain continues, make an appointment with a podiatrist.

Podiatrists specialize in all things foot and ankle. They can treat certain conditions in the office, as well as recommend products, pain medications and therapies to help relieve or heal pain. Most are also foot and ankle surgeons who can provide more advanced care when needed.

Heel pain – the causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment

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06 April

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

For 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 examinations 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…

Up to 1 business day

Available with house call

RUB 810

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Anti-Chlamydia tr.-IgA

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

Up to 2 working days

Available with home visit

830 RUB

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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…

Up to 1 business day

Available with home visit

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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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 to 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.

Pain associated with inflammation of the tendons and ligaments

• 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.

Test type	Diagnostic target
Complete blood count	Detects inflammation, anemic decrease in hemoglobin, changes in platelet levels in clotting problems
Blood chemistry	Shows changes in metabolic processes, diabetic manifestations, arthritic disorders, infectious component
Tumor marker test	Required for suspected neoplasms in bone or adjacent tissues
Radiography	Takes pictures of the bone and soft tissues of the foot. Indicated for post-traumatic pain, suspected degenerative-dystrophic processes, pain of uncertain cause or inaccurate localization
ultrasound	Expands diagnostic information for arthritis, bursitis, inflammatory lesions
CT, MRI	Clarify the state of tissue structures in any type of pathology
Punctures	If neoplastic lesions or infections are suspected, bone or bursal punctures are taken

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.

Material checked by an expert

Marshenin Konstantin Vladimirovich

Chief physician. Neurologist, chiropractor, vertebrologist, psychoneurologist, doctor of the highest qualification category

Experience – 22 years

Video testimonials from patients

Articular block in the neck

Hernia in the lower back and neck

I came to Dr. Length’s clinic with spinal problems. With two intervertebral lower hernias and two intervertebral hernias in the neck. I was assigned a comprehensive 10 step program. In 4 months, my lower vertebrae completely disappeared and crunches in my neck disappeared …

Hernia of the lumbosacral region

“After the first time, my back stopped hurting. I felt relieved. Now 7 sessions have already passed and the back really does not hurt. I began to forget about it. And at first it hurt a lot.”

Inflammation of the sciatic nerve

“For 4 months I suffered from severe inflammation of the sciatic nerve on the right side. After the first visit, relief came immediately within six hours. After 6 courses, the pain was almost gone.

Pain in the lower back and leg

Yakovleva Natalya Mikhailovna
Head of the department, surgeon of the highest category, oncologist-mammologist
I want to express my deep gratitude for the fact that I was put on my feet in the truest sense of the word. I came to the clinic a month and a half ago with severe pain in the lower back and leg. These complaints were long enough and the treatment that I used in the past was ineffective. Fortunately, I ended up in the clinic of Dr. Length and his team of super professionals!

Osteochondrosis of the cervical spine

“I applied 2 months ago with osteochondrosis of the cervical spine. I have a sedentary job and my neck muscles were very cramped. It was impossible to work. Before that, I went to other doctors, but this did not solve my problem. For 2 months I have a fairly positive dynamics. Every week it gets better and better.”

Bechterew’s disease

“I have had Bechterew’s disease for 10 years. The vertebrae began to move out, I began to slouch. I turned to other chiropractors, very famous, media ones. In the end, I didn’t get any results. After 2 sessions I felt much better. Now I don’t have any pain.”

Pain in the spine

“I came in with problems in my back, cervical, thoracic and lumbar spine. I was prescribed procedures, had a massage, and was assigned to do physical education at home. This made it much easier for me. I’m already turning my head. I have no pain.”

Shoulder-shoulder periarthrosis

I went to the clinic with severe pain in my shoulder. My hand did not rise, I could not sleep at night, I woke up from pain. After the first treatment session, I felt much better. Somewhere in the middle of the course, my hand began to rise, I began to sleep at night.

Arthrosis of the knee joint, 2nd degree

She came in with a very serious illness. I could not walk, I have arthrosis of the 2nd degree of the knee joint. I went through a course of treatment at the Clinic and now I am going 100%.

Herniated disc

“I came to the clinic after I had back pain and it turned out to be a herniated disc. I went to other places, but they only relieved attacks of pain. Hope for a return to normal life was given only by Sergei Vladimirovich, his golden hands!

Scoliosis

“Since I was a teenager, I have suffered from scoliosis in the thoracic region. I felt a feeling of discomfort, tension, periodic pain in the spine. I turned to various specialists, a massage therapist, an osteopath, but I did not feel a strong effect. After treatment, Length S.V. I almost have a straight spine. Currently, I do not feel any problems and discomfort.”

Intervertebral hernia

“At the 5th-6th session there was an improvement. I felt much better. The pain is gone. Improvement progressed more and more each time. Lesson 10 today. I feel great.”

Pain in the lumbar and cervical region

“I am 21 years old. I went to the clinic with discomfort in the lumbar and cervical region. I also sometimes had sharp pains. After undergoing therapy, I felt a significant improvement in my back. I have no pain. The condition as a whole has improved.”

Back pain

“At the beginning of the path of treatment, my back hurt very much. I could no longer walk. I take 5 steps and stop. My entire journey consisted of such stops. In the very first procedure, I left the office with no pain in my spine. ”

Cervical hernia

“I came in with a problem in my neck and my right arm was very sore. The neck did not turn, the hand did not rise. After the 3rd session, I felt better. After the 5th, all this pain began to decrease. It turns out I have 2 hernias in my cervical vertebrae. After the sessions, I did an MRI and one hernia decreased. Now he began to move, his hand earned.

Pain in the neck

“I went to Dr. Long because I had a very bad pain in my neck on the right side. I fell on a snowboard 5 years ago, even went to an osteopath, but somehow it didn’t really help. Now everything is fine, there are some consequences left, the muscles were spasmodic. When I came, I had steel muscles, now my neck is very soft.”

Pain in the thoracic region

“I went to the clinic with back pain, namely in the thoracic region. After 10 sessions of treatment, I could already calmly go about my usual business, sit at work until lunch, without howling in pain. Now I’ve come back for an adjustment after 2 months. I’m fine, my back doesn’t hurt.”

Hernia and protrusion

“I came to the clinic with L4-L5 hernia and L5-S1 protrusion. Today the course of treatment has ended. Lower back hurt, it was difficult to bend down. After completing the course and receiving instructions in the form of physical exercises, it became much easier. After a month of treatment, I do not feel any stiffness of movements. ”

Pain in the lower back and hip joint

“I have had back pain since I was young. When they became unbearable, I went to Dr. Length’s clinic. Already after the first procedure, the pain in the hip joint was gone. After the third procedure, the shooting pains in the lower back stopped.

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