What causes heel pain? 8 possible conditions
Your foot and ankle are made up of 26 bones, 33 joints, and more than 100 tendons. The heel is the largest bone in your foot. If you overuse or injure your heel, you may experience heel pain. This can range from mild to disabling.
If you develop heel pain, you can try several methods at home to ease your discomfort. For example:
- rest as much as possible
- apply ice to the heel for 10 to 15 minutes twice a day
- use over-the-counter pain medications
- wear shoes that fit properly
- wear a night splint, a special device that stretches the foot while you sleep
- use heel lifts or shoe inserts to reduce pain
If these home care strategies do not ease your pain, you will need to see your doctor. He or she will perform a physical exam and ask you about your symptoms and when they began. Your doctor may also take an X-ray to determine the cause of your heel pain. Once your doctor knows what is causing your pain, he or she will be able to provide you with the appropriate treatment.
In many cases, your doctor may prescribe physical therapy. This can help to strengthen the muscles and tendons in your foot, which helps to prevent further injury. If your pain is severe, your doctor may provide you with anti-inflammatory medications. These medications can be injected into the foot or taken by mouth.
Your doctor may also recommend that you support your foot as much as possible — either by taping the foot or by using special footwear devices.
In very rare cases, your doctor may recommend surgery to correct the problem, but heel surgery often requires a long recovery time and may not always relieve your foot pain.
Treatment for plantar fasciitis
The vast majority of patients recover with conservative treatments (designed to avoid radical medical therapeutic measures or operative procedures) within months.
Non-steroidal anti-inflammatory drugs
(NSAIDs) – medications with analgesic (pain reducing), antipyretic (fever reducing) effects. In higher doses they also have anti-inflammatory effects – they reduce inflammation (swelling). Non-steroidal distinguishes NSAIDs from other drugs which contain steroids, which are also anti-inflammatory. NSAIDs are non-narcotic (they do not induce stupor). For patients with plantar fasciitis they may help with pain and inflammation.
Home care such as rest, ice-pack use, proper-fitting footwear and foot supports are often enough to ease heel pain.
a corticosteroid solution is applied over the affected area on the skin; an electric current is used to help absorption. Alternatively, the doctor may decide to inject the medication. However, multiple injections may result in a weakened plantar fascia, significantly increasing the risk of rupture and shrinkage of the fat pad covering the heel bone. Some doctors may use ultrasound to help them make sure they have injected in the right place.
Corticosteroids are usually recommended when NSAIDs have not helped.
Physical therapy (physiotherapy)
A qualified/specialized physical therapist (UK: physiotherapist) can teach the patient exercises which stretch the plantar fascia and Achilles tendon, as well as strengthening the lower leg muscles, resulting in better stabilization of the ankle and heel. The patient may also be taught how to apply athletic taping, which gives the bottom of the foot better support.
The splint is fitted to the calf and foot; the patient keeps it on during sleep. Overnight the plantar fascia and Achilles tendon are held in a lengthened position; this stretches them.
Insoles and orthotics (assistive devices) can be useful to correct foot faults, as well as cushioning and cradling the arch during the healing process.
Extracorporeal shock wave therapy
Sound waves are aimed at the affected area to encourage and stimulate healing. This type of therapy is only recommended for chronic (long-term) cases, which have not responded to conservative therapy.
The plantar fascia is detached from the heel bone. This procedure is only recommended if nothing else works. There is a risk that the arch of the foot is subsequently weakened.
See a list of possible causes in order from the most common to the least.