Heel Pain

The feet take lots of abuse, simply by walking one mile you put 60 tons of stress on each foot. Many of our activities such a playing sports where we pound our feet on hard surfaces which irritates sensitive tissues can lead to heel pain. This is the most common problem affecting the foot and ankle. Usually the problem will heal itself with rest, however if you ignore the pain and keep on doing the same things that started the pain it will get worse and it could become a chronic condition leading to more problems. If you are experiencing heel pain you should see your doctor and explain to him or her exactly where it hurts and for how long.

Conditions that cause heel pain generally fall into two main categories: pain beneath the heel and pain behind the heel.

Pain Beneath the Heel

This type of pain is usually caused by inflamed tissues on the bottom of your foot such as:

Stone bruise. Stepping on a hard object such as a rock can cause this or stone, this will bruise the fat pad on the underside of your heel. It sometimes may look discolored. The pain goes away gradually with rest.
Plantar fasciitis (subcalcaneal pain). This can come from too much running or jumping, this can inflame the tissue band (fascia) connecting the heel bone to the base of the toes. The pain is felt under your heel and may be mild at first but increase when you start walking in the morning. You may need to do special exercises, take medication to reduce swelling and wear a heel pad in your shoe.
Heel spur when you have had the condition plantar fasciitis for a long time, a heel spur (calcium deposit) may form where the fascia tissue band connects to your heel bone. A doctor will usually take an X-ray to see the bony protrusion, which can vary in size. Treatment is usually the same as for plantar fasciitis: rests until the pain subsides, do special stretching exercises and wear heel pad shoe inserts.



Pain Behind the Heel

Usually this is caused by an inflamed the area where the Achilles tendon inserts into the heel bone (retrocalcaneal bursitis). Often people get this by running too much or wearing shoes that rub or cut into the back of the heel. This pain will start out slowly and increase over time, causing the skin to thicken, get red and swell. You may have a bump on the back of your heel that feels tender and warm to the touch. The pain flares up when become active after resting. Many times it can hurt too much to wear normal shoes. Your doctor will perform an X-ray to see if you have a bone spur.

You will be instructed to rest from the activities that caused the problem, doing certain stretching exercises, using pain medication and wearing open back shoes.

Your doctor may have you wear a 3/8" or 1/2" heel insert.
You can stretch your Achilles tendon by leaning forward against a wall with your foot flat on the floor and heel elevated with the insert.
You can take nonsteroidal anti-inflammatory medications for pain and swelling, such as Aspirin or Motrin.
You can also get pain relieve from placing ice on the back of the heel to reduce inflammation.