Heel pain may develop when you pound your feet on hard surfaces playing sports or wear shoes that irritate sensitive tissues. A sore heel will usually get better on its own if you give it enough rest. Unfortunately, many people try to ignore the early signs of heel pain and keep on doing the activities that caused it and this can lead to chronic pain. Conditions that cause heel pain generally fall into two main categories: pain beneath the heel and pain behind the heel.
Pain beneath the Heel
If it hurts under your heel, you may have one or more conditions that cause inflammation of the tissues on the bottom of your foot:
Stone bruise: By stepping on a hard object, you can bruise the fat pad on the bottom side of your heel. It may or may not look discoloured.
With rest, the pain subsides gradually.
Plantar fasciitis: It is the most common cause of heel pain. In this condition, the pain is more severe in the morning but becomes less painful as the day continues. It occurs due to tiny tears in the plantar fascia.The plantar faschia is a tissue band that connects the bottom of the heel bones to the ball of the foot and is involved in walking and running, giving spring to the step. If left untreated, the symptoms usually worsen and can lead to problems with the knee and hip and can cause back pain due to difficulty walking. Those who frequently stand or walk throughout the day or those who run are most likely to develop plantar fasciitis.
Treatment and prevention of plantar fasciitis:
The following steps will help prevent plantar fasciitis or help keep the condition from getting worse if you already have it:
- The primary treatment is rest.
- Cold packs application to the area for 20 minutes several times a day or after activities give some relief.
- Over-the-counter pain medications can help manage the pain; consult your healthcare professional.
- Shoes should be well cushioned, especially in the midsole area, and should have the appropriate arch support. Some will benefit from an orthotic shoe insert, such as a rubber heel pad for cushioning. Orthotics should be used in both shoes, even if only one foot hurts. Going barefoot or wearing slipper puts stress on your feet. Put on supportive shoes as soon as you get out of bed.
- Calf stretches and stretches using a towel (place the towel under the ball of your feet and pull gently the towel toward you and hold a few seconds) several times a day, especially when first getting up in the morning. Stretching the Achilles tendon at the back of the heel is especially important before sports, but it is helpful for nonathletes as well.
- Increasing your exercise levels gradually.
- Staying at a healthy weight.
- Surgery is very rarely required.
Heel spur is a calcium deposit that may form where the fascia tissue band connects to your heel bone, when plantar fasciitis continues for a long time. The suggested treatment for heel spur is:
- Resting until the pain subsides.
- Doing stretching exercises.
- Wearing heel pad shoe inserts.
Pain behind the Heel
By running too much or wearing shoes that rub or cut into the back of the heel, the area where the Achilles tendon inserts into the heel bone may get inflamed. Pain behind the heel may build slowly over time, causing the skin to thicken, redden and swell. A bump on the back of the heel that feels tender and warm to the touch may develop. The pain flares up at the start of an activity and it often hurts too much to wear normal shoes. Treatment includes:
- Resting from the activities that caused the problem.
- Stretching the Achilles tendon by leaning forward against a wall with the foot flat on the floor and the heel a little bit elevated using an insert underneath your heel.
- Using pain medication and placing ice on the back of the heel to reduce inflammation.
- Wearing open back shoes.
- Using heel insert in your shoes.
When to consult a doctor
- If you think you might have plantar fasciitis. The sooner a doctor diagnoses and treats your problem, the earlier you will have pain relief.
- If you have heel pain with fever, with redness or warmth in your heel, or with numbness or tingling in your heel.
- If you have pain that continues when you are not standing or bearing any weight on your heel.
- If you have a heel injury that results in pain when you put weight on your heel.
- If heel pain lasts more than a week, even after you have tried rest, ice, over-the-counter pain medicine or other home treatment.