Heel Pain

An Overview

Heel pain is a common symptom that has many possible causes. Although heel pain sometimes is caused by a systemic (body-wide) illness, such as rheumatoid arthritis or gout, it usually is a local condition that affects only the foot. The most common local causes of heel pain include.

Causes of Heel pain

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The most common causes of heel pain are plantar fasciitis (bottom of the heel) and Achilles tendinitis (back of the heel).

Plantar fasciitis:

Plantar fasciitis is a painful inflammation of the plantar fascia, a fibrous band of tissue on the sole of the foot that helps to support the arch. Plantar fasciitis occurs when the plantar fascia is overloaded or overstretched. This causes small tears in the fibers of the fascia, especially where the fascia meets the heel bone. Plantar fasciitis may develop in just about anyone but it is particularly common in the following groups of people: people with diabetes, obese people, pregnant women, runners, volleyball players, tennis players and people who participate in step aerobics or stair climbing.

Heel spur:

A heel spur is an abnormal growth of bone at the area where the plantar fascia attaches to the heel bone. It is caused by long-term strain on the plantar fascia and muscles of the foot, especially in obese people, runners or joggers. As in plantar fasciitis, shoes that are worn out, poorly fitting or poorly constructed can aggravate the problem.

Calcaneal apophysitis:

In this condition, the center of the heel bone becomes irritated as a result of a new shoe or increased athletic activity. This pain occurs in the back of the heel, not the bottom. Calcaneal apophysitis is a fairly common cause of heel pain in active, growing children between the ages of 8 and 14. Although almost any boy or girl can be affected, children who participate in sports that require a lot of jumping have the highest risk of developing this condition.

Bursitis:

Bursitis means inflammation of a bursa, a sac that lines many joints and allows tendons and muscles to move easily when the joint is moving. In the heel, bursitis may cause pain at the underside or back of the heel. In some cases, heel bursitis is related to structural problems of the foot that cause an abnormal gait (way of walking). In other cases, wearing shoes with poorly cushioned heels can trigger bursitis.

Pump bump:

This condition, medically known as posterior calcaneal exostosis, is an abnormal bony growth at the back of the heel. It is especially common in young women, in whom it is often related to long-term bursitis caused by pressure from pump shoes.

• Achilles tendinitis
• Achilles tendon rupture
• Bone tumor
• Bursitis (joint inflammation)
• Haglund’s deformity
• Heel spur
• Osteomyelitis (a bone infection)
• Paget’s disease of bone
• Peripheral neuropathy
• Plantar fasciitis
• Reactive arthritis
• Retrocalcaneal bursitis
• Rheumatoid arthritis (inflammatory joint disease)
• Sarcoidosis (collections of inflammatory cells in the body)
• Stress fractures
• Tarsal tunnel syndrome

What are the symptoms of Heel Pain

The most common symptoms related to heel pain are listed below. If anyone sees any of these symptoms in them, they must address it and take the right precautionary measures to prevent further complications.
• Chronic Pain
• Sudden Pain
• Redness
• Swelling
• Walking is difficult
• Bursitis: Bursitis involving the heel causes pain in the middle of the undersurface of the heel that worsens with prolonged standing and pain at the back of the heel that worsens if you bend your foot up or down.
• Pump bump: This condition causes a painful enlargement at the back of the heel, especially when wearing shoes that press against the back of the heel.
• Local bruises: Heel bruises, like bruises elsewhere in the body, may cause pain, mild swelling, soreness and a black-and-blue discoloration of the skin.
• Achilles tendonitis: This condition causes pain at the back of the heel where the Achilles tendon attaches to the heel. The pain typically becomes worse if you exercise or play sports, and it often is followed by soreness, stiffness and mild swelling.

Diagnosis

The differential diagnosis of heel pain is extensive, but a mechanical etiology is the most common. The specific anatomic location of the pain can help guide diagnosis. The most common diagnosis is plantar fasciitis, which leads to medial plantar heel pain, especially with the first weight-bearing steps after rest. Other causes of plantar heel pain include calcaneal stress fractures (progressively worsening pain after an increase in activity or change to a harder walking surface), nerve entrapment or neuroma (pain accompanied by burning, tingling, or numbness), heel pad syndrome (deep, bruise-like pain in the middle of the heel), and plantar warts.
Following are the assessments used to diagnose the condition:
• X-ray
• Physical Examination

Treatment

Here are the most common treatment methods that cure the condition:

  • Therapies focus on easing pain and inflammation, improving foot flexibility and minimizing stress and strain on the heel. These treatments include: Injections: Steroid injections can ease pain and swelling. Steroid injections should rarely, if ever, be given for a tendon problem but may certainly help for plantar fasciitis and bursitis.
  • Rest: If the condition is addressed at its initial stages, it can be fixed simply by resting.
  • Icing: Icing helps reduce swelling and pain in the joints. The point where the pain is severe must be iced multiple times a day.
  • Medication: Painkillers and anti-inflammatory medicines may be prescribed to reduce pain and inflammation.
  • Shoe Inserts: 3/8″ or 1/2″ heel inserts may be recommended by the doctors to the patients with heel pain.
  • Surgery: When non-surgical treatments don’t help, doctors may have to perform surgery to reduce the pain

Physical Therapy: Physical therapy that involves stretching and exercise will help strengthen the muscles and reduce the pain.

Prevention

Here are a few preventive measures that one can use to avoid any complications caused by the condition:

  • Wear shoes fit properly
  • Wear the right shoes
  • Stretch your muscles
  • Pace yourself
  • Rest

Hope this Symptoms and cure article will be helpful to all. Do not forget to share your valuable suggestions if any.

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