Heel pain is a common complaint impacting daily activities, ranging from a mild ache to sharp pain. It often arises from various conditions affecting the bones, ligaments, tendons, and fatty tissues in the foot.
Common Causes of Heel Pain
Plantar Fasciitis is a common cause of heel pain, involving inflammation of the plantar fascia, a thick tissue band. Repetitive strain causes sharp, stabbing heel pain. Achilles Tendinopathy involves degeneration or inflammation of the Achilles tendon. Pain is felt at the back of the heel and worsens with activity.
Heel Spurs are bony growths, often accompanying Plantar Fasciitis. Though not always painful, they contribute to discomfort when surrounding tissues inflame. Stress fractures are small cracks from repetitive stress. They cause deep, aching pain intensifying with activity.
Retrocalcaneal Bursitis is inflammation of the bursa at the back of the heel. It causes pain and swelling, aggravated by pressure or movement. Fat Pad Atrophy occurs when the fatty tissue under the heel thins, reducing cushioning and causing a bruised sensation. This loss makes walking on hard surfaces uncomfortable.
For children and adolescents, Sever’s Disease (calcaneal apophysitis) is an inflammation of the heel’s growth plate. It is exacerbated by physical activity and resolves as bones mature.
Recognizing Specific Symptoms
Plantar Fasciitis presents as sharp, stabbing pain, noticeable with first steps in the morning or after rest. While pain may decrease with activity, it returns or worsens after prolonged standing or walking.
Achilles Tendinopathy causes pain and stiffness, especially upon waking or after inactivity. Discomfort increases during or after running or jumping, and the tendon may feel tender.
Symptomatic heel spurs are often associated with plantar fasciitis pain, causing discomfort. A heel bone stress fracture causes deep, aching pain intensifying with activity and improving with rest. Localized tenderness can also be present with pressure.
Retrocalcaneal bursitis causes pain and swelling at the back of the heel. It worsens with pressure from shoes or during ankle movements. Fat pad atrophy causes a deep, bruised sensation, more pronounced when walking on hard surfaces due to reduced cushioning.
Sever’s Disease in children causes pain, especially during or after sports. The heel can also be tender when squeezed on both sides.
When to Consult a Healthcare Professional
Consult a healthcare professional if heel pain is severe enough to prevent weight-bearing or if its onset is sudden without clear injury. Seek medical attention if heel pain is accompanied by swelling, redness, warmth, or fever, as these may suggest an infection or inflammatory process requiring prompt diagnosis.
Numbness or tingling in the foot or toes alongside heel pain warrants professional evaluation, as these sensations indicate nerve involvement. If heel pain does not improve after several weeks of home care, or if it significantly interferes with daily activities, consult a medical professional. For children, if heel pain does not resolve with rest or limits participation, a doctor should be consulted to rule out conditions like Sever’s Disease.
Home Management and Prevention
Initial home management for heel pain involves reducing aggravating activities, allowing rest. Applying ice for 15-20 minutes several times daily reduces inflammation and discomfort. Over-the-counter pain relievers (NSAIDs) provide temporary relief, though consult a doctor or pharmacist before regular use.
Wearing supportive footwear with arch support and cushioning helps manage heel pain and prevent recurrence. Calf and plantar fascia stretches improve flexibility and reduce tension. Perform these consistently without causing increased pain.
Preventive measures include ensuring shoes provide support and avoiding high heels that stress the heel. Gradually increasing physical activity allows the body to adapt and reduces overuse injuries. Maintaining a healthy weight lessens the load on feet and heels, decreasing stress on the plantar fascia. Regularly incorporating foot and calf stretches maintains flexibility, and resting when pain occurs prevents minor discomfort from worsening.