Heel pain is a problem that can—and does—affect individuals from all demographics. In part, this can be attributed to the fact we place a tremendous amount of force on our feet with every step we take. There are several different conditions that can cause heel pain.
When you come to
Plantar fascia is the band of tissue along the sole of your foot and is responsible for supporting your arch. Most problems with the plantar fascia does not involve inflammation although the term fasciitis (“itis” refers to inflammation). The symptom for plantar fasciitis is a sharp pain under your heel. It is caused by an overuse injury, brought on by repeated trauma over time.
The actual problem tends to be deterioration in this strong ligament, which then impacts the way it functions. When it’s damaged, the tissue doesn’t expand and contract properly. While you are at rest (asleep or sitting for a long period), the tissue contracts and tightens up. When you first put weight on it again, the fascia can’t relax as it should to absorb your weight. Instead, it pulls against the heel bone, causing a stabbing pain under your heel. Sometimes bone spurs form on the heel bone where the fascia is attached.
After you move around a bit, and the fascia limbers up, the pain disappears, only to come back again after the next period of inactivity. This gradually gets worse as time goes on, until you are unable to walk any distance without pain.
Fortunately, conservative treatment is often quite effective for this problem. This could include rest from activity, stretching, night splints, anti-inflammatory medication, “shoe therapy” (changes to the types of footwear you normally choose), orthotics to correct any biomechanical factors, radio pulse therapy (lower shockwave therapy), laser therapy, or possibly cortisone injections for pain. Rarely is it necessary to use more invasive treatments like surgery to correct the condition.
If the pain is behind your ankle (just above the heel), an injury or inflammation of the Achilles tendon is likely to blame. This strong tissue band connects your heel bone to your calf muscle and moves your foot up and down, so it can easily be damaged from overuse.
Repetitive strain causes tiny fibers in the Achilles to fray and tear. When these fibers break down, the body responds with inflammation and swelling in the area. You will probably experience discomfort, which can range from a dull, mild ache all the way up to significant pain. This is particularly evident during athletic activities. The pain is usually worse after activity, and then goes away with rest. Other common symptoms include stiffness and tenderness, a thickening of the tendon at the site of the injury, and even bone spurs in the area where the tendon inserts into the heel.
You can think of the plantar fascia, heel bone, and Achilles tendon as a continuous unit, so problems in one area can affect the others as well. That means remedies such as stretching the calf muscles can help treat both Achilles tendinitis and plantar fasciitis. If the Achilles tendon is completely torn during an injury it may require surgery for complete healing.
Other Sources of Heel Pain
Your pain and discomfort could also be attributed to any of a number of other problems, such as:
- Bruise or contusion (usually from landing on something hard)
- Bursitis (inflamed bursa sac between bone and tendon)
- Fracture of the heel bone
- Haglund’s deformity or bone growth at the back of the heel
- Rheumatoid arthritis or gout
- Sever’s disease – a growth plate problem causing pain in pre-teen and teen years
The good news when it comes to these various conditions is that they are often successfully resolved with the use of conservative (nonsurgical) treatment. There are many different options and methods we may use when creating our unique treatment plan specifically for you. Some of the components include rest, ice, medication, stretches, physical therapy, footwear changes, orthotic devices, and corticosteroid injections. In some cases, we may also recommend effective laser therapy to reduce pain and encourage faster healing within the area. Your diagnosis will determine which options we use.
You won’t know exactly what is wrong unless you come in and have us evaluate your problem. When you have run out of both
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