FOOT & ANKLE

Heel Pain

The heel is made up of the calcaneus bone and supported by a network of muscles, tendons, ligaments and soft tissues, which together support the weight of the body and stress during movement. Heel pain is a common symptom of excessive strain placed on these structures. A sore heel will usually get better on its own without surgery if you give it enough rest. However, many people try to ignore the early signs of heel pain and keep on doing the activities that caused it. This could lead to the injury getting worse and could become a chronic condition leading to more problems.

Symptoms

Heel pain may be felt under or behind the heel, mostly during walking, jogging and running. It may be sharp and stabbing when you first stand up early in the morning or get up after sitting for long hours. Pain may also be associated with swelling, inflammation, numbness and/or a tingling sensation.



Causes

Heel pain can be caused by obesity, abnormal walking style, standing or walking or running on hard surfaces and wearing ill-fitting shoes. Some of the conditions related to heel pain include:

  • Plantar Fasciitis: inflammation of the ligament that connects the heel bone to the toes.
  • Bursitis: swelling of a bursa (fluid-filled sac) at the back of the heel.
  • Achilles Tendinitis: swelling of the Achilles tendon that connects the calf muscle and heel bone.
  • Bone Spurs: extra growth of bone.
  • Calcaneal Fracture.
  • Haglund’s Deformity: bone enlargement at the back of heel.
  • Tarsal Tunnel Syndrome: compression of nerves at the back of the foot.
  • Rheumatoid Arthritis: autoimmune disease of the joints

Diagnosis

Diagnosis is made by medical consultation and examination, taking the patient's past medical history and performing various tests on the foot. Sometimes an X-ray, MRI or CT scan may be requested to confirm diagnosis.



Treatment Options

Non Operative Treatment

Treatment of heel pain completely relies on the causes and location if it is pain beneath or behind the heel. Conventional treatments include:

  • Rest from activities that causes stress on the heel
  • Applying ice packs to help reduce pain and inflammation
  • Regular exercise, foot massage and stretches of the foot
  • Wearing proper shoes, heel cups, professional heel straps and night splints
  • Anti-inflammatory medication (topical or oral)
  • Corticosteroid injections (if indicated)
  • Extracorporeal shockwave therapy (EST) may be performed where high-energy soundwaves are delivered to treat nerve problems

Preventative measures include wearing properly fitted shoes, reducing weight if you are overweight or obese and using shoe inserts.


Surgery

Surgery may be recommended in cases of heel spurs, bursitis and fracture of the heel bone. 

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