Heel Pain: Causes, Treatments, and Prevention

Why do my heels hurt?

Heel pain is a common condition that can affect people of all ages and is usually the result of overuse, injury, or an underlying condition. It often occurs at the bottom or back of the heel and can range from mild discomfort to severe pain, which significantly impacts daily activities such as walking and standing.

Causes of heel pain

Heel pain can have several different causes, which can be grouped into two main categories: pain beneath the heel (plantar) and pain behind the heel (posterior).

Causes of pain beneath the heel

• Plantar fasciitis:

  • Plantar fasciitis is one of the most common causes of heel pain. It occurs when the plantar fascia, a thick band of tissue that connects your heel bone to your toes, becomes inflamed. Plantar fasciitis pain usually worsens in the morning or after periods of rest.

• Heel spurs:

  • A bony growth that forms on the heel bone, often associated with plantar fasciitis. Heel spurs are caused by calcium deposits that build up over time, typically due to stress on the foot muscles and ligaments.

• Stone bruise:

  • Caused by stepping on a hard object like a rock, leading to a localised bruise and tenderness under the heel.

• Tarsal tunnel syndrome:

  • This is caused by compression of the posterior tibial nerve, leading to pain and sometimes tingling or numbness around the heel and foot.

Causes of back of heel pain

• Achilles tendonitis:

  • Achilles tendonitis is an inflammation of the Achilles tendon, which connects the calf muscle to the heel bone. This pain is often due to overuse, particularly in runners or people who increase their physical activity suddenly.

• Bursitis:

  • Inflammation of the bursa, a fluid-filled sac located between the heel bone and Achilles tendon. This condition typically results from repetitive stress or pressure on the heel.

• Sever’s disease (calcaneal apophysitis):

  • A common cause of heel pain in children and adolescents caused by inflammation of the growth plate in the heel. It is often seen in physically active children.

• Haglund’s deformity:

  • A bony enlargement on the back of the heel that leads to inflammation, often caused by wearing tight or stiff shoes that irritate the area. 

Symptoms of heel pain

The symptoms of heel pain can vary depending on the underlying cause, but common signs include:

• Sharp, stabbing, or throbbing pain: 

  • Sharp pain may be felt either under the heel or at the back of the heel, and it may worsen with walking or standing.

• Stiffness and tenderness: 

  • The affected area may feel stiff, especially in the morning or after periods of inactivity.

• Swelling and redness: 

  • Inflammation or irritation of the tissues around the heel can cause swelling, redness, or warmth.

• Difficulty walking: 

  • Heel pain may limit your ability to walk comfortably, especially on hard surfaces or for long periods.

If you are experiencing any of these symptoms or if they are getting worse over time, don’t hesitate to request an appointment with our specialists at Thomson Medical for an accurate diagnosis and personalised treatment plan and physical therapy.

Diagnosis of heel pain

Medical professionals can determine the causes of heel pain through:

• Medical history: 

  • Your doctor will ask about your symptoms, activities, and footwear to help identify potential causes.

• Physical examination: 

  • Your doctor will perform a physical exam on your heel to check for areas of tenderness, swelling, or deformity.

• Imaging tests: 

  • Your heel may be examined with MRI scans, X-ray, or ultrasound scans to look for bone spurs, stress fractures, or soft tissue damage.

Treatment options for heel pain

Treatment depends on the cause and severity of the pain, as well as your overall health condition. Common options include:

Home remedies for heel pain relief

• Rest and activity modification:

  • Avoiding activities that aggravate the heel pain, such as running or prolonged standing, can give the affected area time to heal.

• Ice therapy:

  • Applying an ice pack to the heel for 15-20 minutes several times a day can help reduce inflammation and pain.

• Footwear changes:

  • Wearing shoes that offer good support, cushioning, and a proper fit can relieve pressure on the heel. Orthotic inserts or heel pads can provide additional support.

• Stretching exercises:

  • Stretching the Achilles tendon, calf muscles, and plantar fascia can improve flexibility and alleviate foot pain. A physical therapist can guide you through specific exercises.

• Night splints:

  • Wearing a splint at night can keep the foot in a stretched position, reducing morning pain associated with conditions like plantar fasciitis.

Medical treatments for heel pain relief

• Non-steroidal anti-inflammatory drugs (NSAIDs):

  • Over-the-counter anti-inflammatory medications such as ibuprofen can help reduce pain and inflammation.

• Physical therapy:

  • Targeted exercises and manual therapies can strengthen the muscles around the heel and improve flexibility, leading to less strain on the affected tissues.

• Corticosteroid injections:

  • For more severe cases, a doctor may recommend injecting a corticosteroid into the affected area to reduce inflammation. These injections are typically only used when other treatments are ineffective.

• Shockwave therapy:

  • This non-invasive treatment uses sound waves to promote healing of soft tissues, such as the plantar fascia.

• Surgery:

  • In rare cases, surgery may be needed to remove bone spurs, release tight tendons, or repair damaged tissues if conservative treatments fail to provide relief.

Preventing heel pain

• Wear supportive footwear: 

  • Choose shoes with good arch support and cushioning, especially if you spend a lot of time standing, walking, or taking part in athletic activities.

• Avoid overuse: 

  • Gradually increase physical activity to avoid putting excessive stress on the heel.

• Stretch regularly: 

  • Stretching the Achilles tendon, calf muscles, and plantar fascia can help prevent tightness that leads to heel pain.

• Maintain a healthy weight: 

  • Being overweight can put additional pressure on the heel, increasing the risk of pain and injury.

• Use orthotics: 

  • If you have flat feet or high arches, orthotic inserts can provide extra support and relieve strain on the heel.

Although it may seem like a minor issue, chronic heel pain may be a sign of other, more serious medical problems. If the injury is severe enough to affect your normal day-to-day activities and quality of life, request an appointment with our specialists at Thomson Medical.

FAQ

What is the most common cause of heel pain?

Plantar fasciitis is the most common cause of heel pain, especially among middle-aged individuals and those who are overweight, active, or spend a lot of time on their feet.

How long does heel pain take to heal?

With proper treatment, mild cases of heel pain may improve within a few weeks. Chronic or severe cases may take several months to heal, especially if conservative treatments are not followed.

Is heel pain serious?

Heel pain is often not serious but can affect your quality of life and mobility. If left untreated, certain conditions like plantar fasciitis or Achilles tendonitis can worsen and may lead to chronic pain or further injury.

When should I see a doctor for heel pain?

You should see a doctor if your heel pain persists for more than a few weeks despite rest and self-care, if the pain is severe or worsening, or if you have swelling, numbness, or difficulty walking.

Can heel pain go away on its own?

In some cases, heel pain may resolve with rest and simple at-home treatments. However, if the underlying cause or lifestyle factors are not addressed, the pain can become chronic or recurrent.

How can I relieve heel pain in the morning?

Morning heel pain is common with conditions like plantar fasciitis. Stretching the calf muscles and plantar fascia before getting out of bed, using night splints, and wearing supportive shoes can help relieve morning discomfort.

What is the best exercise for heel pain?

Stretching exercises such as heel raises, calf stretches and plantar fascia massage that target the Achilles tendon, calf muscles, and plantar fascia are effective for relieving heel pain. Consult a physical therapist for a personalised treatment plan.

Can losing weight help with heel pain?

Yes, losing excess weight can help with pain relief as it reduces the stress placed on the feet, which may alleviate or prevent heel pain.

What type of shoes should I wear if I have heel pain?

Wearing proper footwear with suitable arch support, cushioning, and a slightly elevated heel can help reduce pressure on the heel. Avoid shoes with thin soles or no arch support, such as flip-flops or high heels.

Heel pain can be debilitating, but it is often manageable with the right approach to treatment and prevention. If you experience heel pain, early diagnosis and intervention can prevent long-term issues and improve your overall foot health.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request  an appointment with Thomson Medical today.