Feeling as though something is lodged in your heel, despite there being no physical object present, can be a disorienting experience. This sensation, often described as a foreign body sensation, is common. Many individuals encounter it, leaving them searching for an explanation when visual inspection reveals nothing out of place.
How Sensations Are Perceived
The human body perceives sensations like touch and pain through a complex network of nerves that transmit signals to the brain. These nerves, known as sensory neurons, detect stimuli from the external environment or internal bodily changes. Once detected, these signals travel along nerve pathways to the spinal cord and then ascend to various brain regions for interpretation.
The brain processes these incoming signals, creating a perception of what is happening in the body. Sometimes, the brain can misinterpret signals or even generate sensations in the absence of a direct external stimulus. This phenomenon can occur in conditions like phantom limb pain, where sensations are felt in an amputated limb, or neuropathic pain, where nerve damage causes abnormal sensations.
Potential Underlying Causes
The sensation of something stuck in the heel can stem from various underlying medical conditions affecting the nerves, tissues, or even areas distant from the heel itself.
One common cause is nerve entrapment or compression, such as tarsal tunnel syndrome. This condition involves the compression of the posterior tibial nerve or its branches as they pass through a narrow space on the inside of the ankle, leading to symptoms like tingling, numbness, burning, or an electrical shock sensation that can extend to the heel and arch of the foot.
Peripheral neuropathy, a broader term for nerve damage in the extremities, can also cause abnormal sensations in the heel. This damage can result from various factors, including diabetes, alcoholism, or vitamin deficiencies, causing tingling, numbness, burning, or a feeling like “pins and needles” in the feet. The altered nerve signals can be misinterpreted by the brain as a foreign object.
Inflammation or irritation of surrounding tissues can similarly create this sensation. Plantar fasciitis, an inflammation of the thick band of tissue running along the bottom of the foot from the heel to the toes, is a frequent cause of heel pain that can feel like something is present. However, the irritation from conditions like plantar fasciitis can lead to localized pressure or nerve irritation that the brain perceives as a foreign body.
Referred pain is another possibility, where discomfort originates in one area but is felt in another. For instance, a pinched nerve in the lower back, such as from sciatica, can cause pain, numbness, or tingling that radiates down the leg and is perceived in the heel, even if no pain is felt in the back itself. The brain misinterprets the origin of the nerve signal, localizing the sensation to the heel. When a clear physical cause is not identified, stress or anxiety can contribute to unusual physical sensations. Psychological factors can influence pain perception and lead to heightened awareness or amplification of minor physical discomforts, including those in the feet.
When to Seek Medical Attention
Consult a healthcare professional if the sensation of something stuck in your heel persists or worsens over time. This includes when the feeling does not resolve with rest or self-care measures. Seek medical attention if the sensation is accompanied by symptoms like increasing pain, numbness, or tingling in your foot or toes.
Other warning signs include noticeable weakness in your foot or difficulty walking normally. If you have a history of injury to the heel or foot, or if you have underlying medical conditions like diabetes, it is important to have persistent heel sensations checked by a doctor. Additionally, any signs of infection, such as redness, swelling, or warmth around the heel area, should prompt a medical visit.
Medical Evaluation and Care
When you consult a doctor for this sensation, the medical evaluation begins with a thorough review of your medical history, including any past injuries or existing conditions. A physical examination of your foot and ankle will assess for tenderness, swelling, range of motion, and nerve function. The doctor may gently tap along nerves or perform specific movements to reproduce your symptoms.
To investigate the cause, imaging tests might be ordered. An X-ray can help identify bone spurs or stress fractures, while magnetic resonance imaging (MRI) provides detailed images of soft tissues, nerves, and ligaments. Sometimes, nerve conduction studies may be performed to assess nerve function and identify nerve damage or compression.
Management approaches begin with conservative measures, such as:
Rest
Applying ice to the affected area
Using supportive footwear with good arch support
Incorporating heel pads or orthotics
Physical therapy exercises can help stretch and strengthen the foot and ankle muscles. Medications, including anti-inflammatory drugs or nerve pain medications, may be prescribed to manage symptoms. Addressing any identified underlying conditions, like managing blood sugar levels in diabetes, is also part of the care plan. If conservative treatments are not effective, a referral to a specialist may be considered for further options.