The typical foot has 26 bones and more than 100 tendons and 33 joints. As you can see, there’s a lot that can go wrong in this relatively small area of the body. Heel pain is a common problem that affects the foot, one that can range from being mildly annoying to debilitating. Here are some of the causes, symptoms, and treatments of this issue, as well as some preventive tips.
The causes of heel pain can vary widely. In some cases, it can be due to plantar fasciitis, while in others it could be some sort of injury (although this is relatively rare). The cause will usually depend on the part of the heel that is affected.1
Pain underneath the heel, for example, could be the result of a stone bruise, which usually occurs when someone steps on something hard such as a rock. A stone bruise affects the fat pad that is directly beneath the heel, and can lead to discoloration in some instances. This is relatively minor, and the discomfort will gradually disappear, as long as you rest the affected area.
There are times, however, where the problem can be the aforementioned plantar fasciitis, which is an inflammation of the plantar fascia, a band of tissue that connects the toes with the heel bone. Or, the problem could be a heel spur. This is a calcium deposit that forms where the fascia connects to the heel bone.
If you have pain in the rear portion of the heel, one reason might be the kinds of shoes you wear. This could result in the development of a bump (sometimes called a “pump bump”) known as Haglund’s deformity. The area where the Achilles tendon connects with the heel bone is notorious for developing painful bumps that gradually develop and start to thicken. Common symptoms include swelling and redness.
Other potential causes include the following:
- Rheumatoid arthritis – Heel pain can sometimes be traced to inflammation in the joints, a major contributing factor to rheumatoid arthritis. This disease usually starts in the hands and feet and then progresses to other joints throughout the body.
- Gout – This is a painful condition caused by excessive levels of uric acid in the blood. Not only can it affect the heel, but other joints as well such as the elbows, knees, fingers, and others.
- Morton’s neuroma – Morton’s neuroma is basically a swollen nerve between the second and third toes.
If you have severe heel pain that doesn’t subside with either rest or the use of over-the-counter medications, there is a chance that you could have Achilles tendonitis, or you might even have torn your Achilles tendon.2 Persistent, serious pain is a sign that you need to see a doctor.
It might seem odd considering how much stress most of us place on our feet on a daily basis, but heel pain is usually not caused by a specific injury. Rather, symptoms tend to gradually develop. They are usually at their worst when you get out of bed in the morning and after you rest for a while. While the discomfort tends to fade when you’re active, it will probably get worse later in the day.
There are times where you simply can’t choose to “fight through” heel pain, but instead need to see a doctor. Some of the more serious symptoms include:
- Pain accompanied by a fever
- Severe discomfort accompanied by substantial swelling
- An inability to bend your foot in a downward position
- Numbness and/or tingling in the area
- An inability to rise up on your toes
- An inability to walk without severe pain
Whether your heel pain is severe or it is annoying to the point to where it’s interfering with your daily activities, you should seriously consider seeing a doctor.
If your symptoms are relatively mild, he or she may recommend that you try home remedies first. These include using over-the-counter pain relievers, resting the area as much as possible, and applying ice to the area to reduce pain and/or swelling. Remember, though, that you should never directly apply ice to the skin, because you could cause permanent damage. You might want to consider changing your shoes to ones that provide added support.
But even if those options don’t work, there is a very good chance that your doctor will be able to successfully treat your heel pain through conservative methods.
He or she, for instance, may prescribe an anti-inflammatory drug in order to help reduce pain, or a topical corticosteroid if the inflammation is severe. Pain-killing injections are sometimes necessary, but you can have too many of these. The reason is the multiple injections present a substantial risk of weakening the plantar fascia to the point that it may rupture.3 They could also increase the risk of shrinking the fat pad that helps cushion the heel bone.
Other options include:
Splints – Some people need to wear a special splint that goes over the foot and calf. This holds the Achilles and plantar fascia in place while stretching them at the same time.
Custom orthotics – These help keep pressure off of the heel and also cushion the area so that it doesn’t experience the normal amount of stress during the day.
Sound wave therapy – Waves of sound can sometimes stimulate healing, a process known as extracorporeal shock wave therapy. While this type of treatment isn’t as intense as it sounds, it’s still not typically recommended unless someone has a chronic problem that hasn’t responded to more conservative forms of treatment.
It’s almost impossible to prevent all types of heel pain, but you can take some steps to reduce the chances you’ll have to deal with this problem. Whenever possible, wear shoes that provide a substantial amount of support to the foot – you should always wear the right shoes whenever you undertake any sort of physical activity. Make sure you stretch properly before any type of workout, and pace yourself so you don’t put too much stress on your body. Maintaining a healthy weight and getting enough rest can also lower your risk.