Experiencing pain when squeezing your heel can be a puzzling sensation, often indicating an underlying issue within the foot’s complex structures. Understanding why this pain occurs is the first step toward relief. This article explores the various reasons behind heel pain when pressure is applied, offering insights into its causes and potential solutions.
The Heel’s Structure and Its Vulnerabilities
The heel is anchored by the calcaneus, or heel bone, the largest bone in the foot, playing a central role in weight-bearing and stability. Beneath it, a dense fat pad acts as a natural shock absorber, protecting the calcaneus from impact during activities like walking or running. Crucial soft tissues, including the strong plantar fascia ligament on the sole and various tendons like the Achilles, surround these structures. When the heel is squeezed, these components are compressed, making any existing inflammation, injury, or thinning more noticeable and painful.
Common Causes of Heel Pain When Squeezed
Pain in the heel when squeezed can arise from several distinct conditions affecting the foot’s intricate structures. Understanding these issues can help clarify the source of discomfort.
Stress Fracture
Microscopic cracks in the calcaneus, often from repetitive stress, can cause localized pain. This type of fracture is aggravated by direct pressure or squeezing the heel. Pain from a calcaneal stress fracture typically worsens with activity and weight-bearing, sometimes feeling like a persistent ache.
Fat Pad Atrophy or Displacement
The protective fat pad beneath the heel bone can thin or shift over time, reducing its cushioning capacity. This thinning, known as fat pad atrophy, leads to increased pain when the heel bears weight or is compressed. The lack of shock absorption makes the underlying bone more vulnerable to pressure-related discomfort, often described as walking on a hard surface without adequate padding.
Plantar Fasciitis (and Heel Spurs)
Plantar fasciitis involves inflammation of the thick band of tissue running along the bottom of the foot from the heel to the toes. While commonly causing pain with first steps in the morning, severe or chronic cases can result in tenderness and pain when the heel bone area is squeezed. Heel spurs, bony growths sometimes associated with plantar fasciitis, can further contribute to localized tenderness upon compression, as they can physically dig into the fat pad.
Bursitis
Bursae are small, fluid-filled sacs that cushion joints and reduce friction between bones and soft tissues. Inflammation of these sacs around the heel, known as bursitis, can cause localized tenderness, swelling, and pain when compressed. This condition often results from overuse or ill-fitting shoes that put pressure on the heel.
Bone Bruise (Contusion)
A direct impact or injury to the heel can cause a bone bruise within the calcaneus. This injury results in pain that intensifies with pressure or squeezing, similar to a deep ache or tenderness. Swelling and tenderness are common symptoms, and the pain can make walking or bearing weight difficult, depending on the severity.
Tarsal Tunnel Syndrome
Tarsal tunnel syndrome involves compression of the posterior tibial nerve as it passes through a narrow space in the ankle. While typically causing burning, tingling, or numbness, localized pressure like squeezing can exacerbate these nerve-related symptoms in the heel. The pain may radiate into the foot or arch, often feeling like a shooting or prickling sensation.
Less common but possible causes for persistent heel pain include bone infections (osteomyelitis) or, rarely, tumors. Osteomyelitis can present with pain, swelling, and warmth, sometimes accompanied by fever or general malaise. These conditions are less frequent but warrant consideration if other causes are ruled out and symptoms persist.
When to Seek Professional Help
While minor heel pain may improve with home care, certain signs indicate the need for professional medical evaluation. Consult a healthcare provider if pain is severe or arises immediately after an injury. Seek medical attention if pain persists for more than a few weeks despite rest and home treatments. Other warning signs include pain that makes walking difficult, significant swelling, redness, or warmth in the heel area. Numbness, tingling, or fever accompanying heel pain also warrant prompt medical assessment. A proper diagnosis is important for effective treatment and to rule out more serious underlying conditions.
Initial Steps for Relief
Several initial self-care measures can provide temporary relief for heel pain. The RICE method (Rest, Ice, Compression, and Elevation) is a common approach. Rest the affected foot by avoiding activities that worsen the pain. Apply ice to the painful area for 15-20 minutes several times a day to reduce inflammation and pain.
Gentle stretching exercises for the calf muscles and plantar fascia can improve flexibility and reduce tension. Wearing appropriate footwear with good arch support and cushioning can reduce stress on the heel and distribute weight more evenly across the foot. Over-the-counter pain relievers, such as NSAIDs, may offer temporary symptom management. These steps are intended as initial measures and should not replace professional medical advice if symptoms persist or worsen.