What causes sharp pain in the heel of your foot. How can you alleviate plantar fasciitis symptoms at home. When should you seek professional help for heel pain. What are the most effective treatments for plantar fasciitis.

Understanding Plantar Fasciitis: The Leading Cause of Heel Pain

Plantar fasciitis is a common condition affecting millions of Americans, characterized by inflammation of the plantar fascia – a ligament extending from the heel to the toes along the bottom of the foot. This inflammation leads to sharp heel pain, particularly noticeable in the morning or after periods of rest.

Is plantar fasciitis only an athlete’s problem. While it’s a frequent injury among athletes, both sedentary and active individuals can develop this condition. Experts believe chronic overload from lifestyle habits or exercise, such as prolonged standing or running, contributes to its development.

Key Symptoms of Plantar Fasciitis

• Sharp pain in the heel, especially during the first steps in the morning
• Pain that improves with movement but worsens after long periods of weight-bearing
• Discomfort in the arch of the foot
• Pain that increases after (not during) exercise

Risk Factors Contributing to Heel Pain and Plantar Fasciitis

Several factors can increase your likelihood of developing plantar fasciitis. Understanding these risk factors can help in prevention and management of the condition.

Common Risk Factors

• Obesity
• Flat feet (pes planus) or high arches (pes cavus)
• Shortened Achilles tendon
• Overpronation (excessive 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
• Inappropriate footwear

Home Remedies for Alleviating Sharp Heel Pain

Can you manage plantar fasciitis symptoms at home. Yes, several self-management techniques can provide relief from acute heel pain:

1. Calf and arch stretches: Keep a towel by your bedside. Before sleep and upon waking, gently pull back on your foot for 30 seconds, repeating three times with 30-second rest intervals.
2. Foot flexing: Flex your feet towards and away from your knees to loosen the feet and reduce pain during initial 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 intervals.

Professional Treatment Options for Plantar Fasciitis

When should you seek professional help for heel pain. If home remedies don’t provide sufficient relief, it’s time to consult a healthcare professional. Physical therapy can be particularly beneficial in treating plantar fasciitis.

Physical Therapy Interventions

• Manual therapy and targeted exercises
• Ice therapy
• Taping techniques

Why is early treatment important. Untreated plantar fasciitis can lead to chronic pain and become more challenging to manage. Seeking help from a physical therapist early can help control painful impairments, improve related limitations, and enhance overall quality of life.

Other Common Causes of Heel Pain

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

Alternative Causes of Heel Pain

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

How can you differentiate between these conditions. The location, timing, and nature of the pain can often provide clues. For instance, Achilles tendinitis typically causes pain at the back of the heel, while plantar fasciitis pain is usually felt on the bottom of the heel.

Preventing Heel Pain and Plantar Fasciitis

Can plantar fasciitis be prevented. While not all cases can be avoided, several strategies can reduce your risk of developing this painful condition:

1. Maintain a healthy weight to reduce stress on your feet
2. Wear supportive, well-fitting shoes
3. Gradually increase the intensity of your workouts
4. Stretch your calves and feet regularly
5. Avoid going barefoot on hard surfaces
6. Replace worn-out athletic shoes
7. Mix high-impact activities with low-impact ones

When to Seek Medical Attention for Heel Pain

While many cases of heel pain can be managed at home or with physical therapy, certain situations warrant immediate medical attention. Recognizing these signs can prevent potential complications and ensure timely treatment.

Warning Signs

• Severe pain and swelling
• Inability to bend your foot downward or walk normally
• Heel pain accompanied by fever, numbness, or tingling
• Pain that persists beyond several weeks despite home treatment

What should you expect during a medical consultation for heel pain. Your healthcare provider will likely perform a physical examination, ask about your symptoms and medical history, and may order imaging tests like X-rays or MRI to rule out other conditions.

Advanced Treatment Options for Persistent Plantar Fasciitis

For cases of plantar fasciitis that don’t respond to conservative treatments, several advanced options are available. These interventions aim to provide long-term relief and promote healing of the plantar fascia.

Advanced Treatment Modalities

1. Extracorporeal shock wave therapy (ESWT): This non-invasive procedure uses sound waves to stimulate healing in the plantar fascia.
2. Platelet-rich plasma (PRP) injections: This treatment uses your own blood cells to promote healing in the affected area.
3. Tenex procedure: A minimally invasive technique that removes damaged tissue from the plantar fascia.
4. Gastrocnemius recession: A surgical procedure that lengthens the calf muscles to reduce stress on the plantar fascia.

How effective are these advanced treatments. Success rates vary, but many patients experience significant improvement in symptoms after undergoing these procedures. However, they are typically considered only after conservative treatments have been exhausted.

The Role of Footwear in Managing and Preventing Heel Pain

Proper footwear plays a crucial role in both preventing and managing plantar fasciitis and other causes of heel pain. Choosing the right shoes can provide necessary support and cushioning, reducing stress on the plantar fascia and promoting proper foot mechanics.

Key Features to Look for in Supportive Footwear

• Firm heel counter to stabilize the foot
• Adequate arch support
• Cushioned sole to absorb shock
• Flexibility at the ball of the foot
• Proper fit with enough room in the toe box

Should you wear special orthotic devices for plantar fasciitis. Custom orthotics or over-the-counter arch supports can provide additional support and help distribute pressure more evenly across the foot. However, it’s best to consult with a podiatrist or physical therapist to determine if orthotics are necessary for your specific case.

The Impact of Lifestyle Factors on Heel Health

Beyond physical factors and activities, various lifestyle elements can influence the development and persistence of heel pain. Understanding and modifying these factors can contribute significantly to both prevention and management of conditions like plantar fasciitis.

Lifestyle Factors Affecting Heel Health

1. Occupation: Jobs that require prolonged standing or walking, especially on hard surfaces, can increase the risk of heel pain.
2. Nutrition: A balanced diet rich in anti-inflammatory foods may help reduce inflammation associated with plantar fasciitis.
3. Hydration: Proper hydration is crucial for maintaining the elasticity of soft tissues, including the plantar fascia.
4. Sleep: Adequate rest allows time for tissue repair and can help manage inflammation.
5. Stress management: High stress levels can increase muscle tension, potentially exacerbating heel pain.

How can you modify your lifestyle to support heel health. Start by assessing your daily routines and gradually implement changes. This might include taking regular breaks to stretch if you have a sedentary job, investing in a supportive mat if you stand for long periods, or incorporating stress-reduction techniques into your daily routine.

The Connection Between Overall Health and Heel Pain

Heel pain, including conditions like plantar fasciitis, doesn’t exist in isolation. Often, it’s connected to or influenced by your overall health status. Understanding these connections can lead to more comprehensive and effective management strategies.

Health Conditions Associated with Increased Risk of Heel Pain

• Diabetes: Can lead to nerve damage (neuropathy) affecting foot sensation and mechanics
• Arthritis: Inflammatory types can affect joints in the foot, altering gait and increasing stress on the heel
• Obesity: Increases pressure on the feet and can lead to changes in foot structure
• Cardiovascular diseases: May affect circulation to the feet, impacting tissue health

How does managing these conditions impact heel health. By effectively managing these underlying health conditions, you may reduce your risk of developing heel pain or improve outcomes if you’re already experiencing it. Always consult with your healthcare provider to develop a comprehensive management plan that addresses both your overall health and specific foot concerns.

Complementary and Alternative Approaches to Heel Pain Management

While conventional medical treatments are often effective for managing heel pain, some individuals find additional relief through complementary and alternative approaches. These methods can be used alongside traditional treatments but should always be discussed with a healthcare provider.

Alternative Therapies for Heel Pain

1. Acupuncture: May help reduce pain and inflammation
2. Massage therapy: Can improve circulation and reduce muscle tension
3. Yoga: Gentle stretching and strengthening exercises may improve foot flexibility and strength
4. Reflexology: Based on the idea that specific points on the feet correspond to other body parts
5. Herbal remedies: Some herbs have anti-inflammatory properties that may help reduce pain

Are these alternative therapies effective for everyone. The effectiveness of these approaches can vary widely between individuals. While some people report significant benefits, scientific evidence supporting these methods is often limited. It’s crucial to approach alternative therapies with an open but critical mind and always in consultation with your healthcare provider.

Long-Term Outlook for Individuals with Chronic Heel Pain

For some individuals, heel pain can become a chronic condition. Understanding the long-term outlook and developing strategies for ongoing management is crucial for maintaining quality of life and preventing recurrence of symptoms.

Strategies for Long-Term Management of Chronic Heel Pain

• Regular exercise and stretching routines
• Maintaining a healthy weight
• Consistent use of supportive footwear
• Periodic check-ins with a healthcare provider or physical therapist
• Modifying activities to reduce stress on the feet
• Using pain management techniques as needed

Can chronic heel pain be completely cured. While many people experience significant improvement or complete resolution of symptoms with appropriate treatment, others may need to manage the condition long-term. The key is to develop a sustainable management plan that allows you to maintain an active, comfortable lifestyle while minimizing pain and preventing flare-ups.

The Future of Heel Pain Treatment: Emerging Technologies and Research

As medical science advances, new technologies and treatment approaches for heel pain continue to emerge. Staying informed about these developments can provide hope and potentially new options for those struggling with persistent heel pain.

Promising Areas of Research in Heel Pain Treatment

1. Regenerative medicine: Including stem cell therapy and growth factor injections
2. Advanced imaging techniques: For more precise diagnosis and treatment planning
3. Wearable technology: To monitor gait patterns and provide real-time feedback
4. 3D-printed orthotics: Customized to individual foot structures with unprecedented precision
5. Novel drug therapies: Targeting specific inflammatory pathways involved in heel pain

How soon might these new treatments be available. While some of these approaches are already in clinical trials, others are still in early research stages. It may be several years before many of these potential treatments become widely available. However, the rapid pace of medical advancement offers hope for improved outcomes in the future.

In conclusion, heel pain, particularly when caused by conditions like plantar fasciitis, can significantly impact daily life. However, with a combination of home remedies, professional treatments, and lifestyle modifications, most people can find relief. By understanding the causes, recognizing symptoms early, and seeking appropriate care, you can take steps towards alleviating heel pain and maintaining healthy, pain-free feet. Remember, persistent or severe heel pain should always be evaluated by a healthcare professional to ensure proper diagnosis and treatment.

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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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 prolonged standing, 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. Tendonitis 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 cartilaginous tissue, which eventually transforms into bone. If the cartilage tissue is overloaded 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 calcaneal tuber apophysis, 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 to 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, DNA detection (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…

Up to 1 business day

Available with home visit

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.

RUB 2,390

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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 over time, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

methods of treatment, diagnosis and causes

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

Anatomical structure of the heel

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

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

Causes of heel pain on foot

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

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

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

Pain in the heel due to injuries

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

Tendon and ligament inflammation pain

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

Heel pain in diseases of the joints

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

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Pain associated with infection

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

Dermatological problems characterized by pain in the heel

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

Diagnosis of the disease

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

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 bursa 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 rapid 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

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

Experience – 22 years

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Back pain

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Cervical hernia

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