Heel Pain

D4S_2607_LargeHeel pain is one of the most common conditions treated by podiatrists. It is often a message
from the body that something is in need of medical attention. Pain that occurs right after an
injury or early in an illness may play a protective role, often warning us about the damage we
have suffered.

Who gets heel pain?

The greatest incidence of heel pain is seen in middle-aged men and women. It is also seen in
those who take part in regular sporting activities, those significantly overweight and on their
feet a lot. Heel pain can also occur in children, usually between 8 and 13, as they become
increasingly active in sporting activities.

The causes of heel pain?

It is thought that higher arches or flatter arches, or feet that roll in too much are causes of heel pain. This can place too much stress on the heel bone and the soft tissues attached to it.

The stress may also result from injury, or a bruise incurred while walking, running or jumping on hard surfaces, wearing poorly constructed footwear, or being significantly overweight.

Systemic diseases such as arthritis and diabetes can also contribute to heel pain.

Complications

Heel spur

One factor sometimes associated with heel pain is the heel spur, a bony growth under the heel
bone. There are no visible features on the heel, but a deep painful spot can be found in or
around the middle of the heel.

Approximately 10 per cent of the population have heel spurs without any pain.

Heel spurs result from strain on the muscles of the foot. This may result from biomechanical
imbalance, a condition occurring in many people.

Plantar fasciitis

Both heel pain and heel spurs are frequently associated with an inflammation of the long band
of tissue that connects the heel and the ball of the foot. The inflammation of this arch area is
called plantar fasciitis.

The inflammation may be aggravated by shoes that lack appropriate support especially in the
arch area, or by chronic irritation that sometimes accompanies an athletic lifestyle.

Other causes of heel pain

  • excessive rolling in of the feet when walking
  • an inflamed bursa (bursitis), a small, irritated sack of fluid at the back of the heel
  • a neuroma (a nerve growth)
  • other soft-tissue growths
  • heel bumps or ‘pump bumps’, a bone enlargement at the back of the heel bone
  • bruises or stress fractures to the heel bone

Overcoming the problem

If pain and other symptoms of inflammation – redness, swelling, heat – persist, you should limit
normal daily activities and consult your local podiatrist.

Your podiatrist may conduct a number of x-rays to look for heel spurs or fractures.

Treatment

Early treatment might involve exercise and shoe recommendations, taping or strapping and
anti-inflammatory medication (such as aspirin). Taping or strapping supports the foot, placing
stressed muscles in a restful state and preventing stretching of the plantar fascia. Other
physical therapies may also be used, including ice-packs and ultrasound.

These treatments will effectively treat the majority of heel and arch pain without
the need for surgery.

Only a relatively few cases of heel pain require surgery. If required, surgery is usually for the
removal of a spur, but also may involve release of the plantar fascia, removal of a bursa, or a
removal of a neuroma or other soft-tissue growth.

Recovery

Your recovery will depend on the cause of your heel pain and your individual health. If you are
suffering with a heel spur or plantar fasciitis, it normally takes about six to eight weeks for a
healthy individual to fully recover. That is when the injured area is fully rested or properly
strapped.

Preventing future problems

Footwear

Wear shoes that fit well – front, back and sides – and have shock-absorbent soles, natural fibre uppers
and supportive heel counters. Do not wear shoes with excessive wear on heels or soles.

Stretches and exercise

Prepare properly before exercising.

Warm-up before running or walking, and do some stretching exercises afterward.

Pace yourself when you participate in athletic activities. If overweight, try non weight-bearing
activities such as swimming or cycling.

Additional control

Your podiatrist may also use taping or strapping to provide extra support for your foot. Orthoses (shoe inserts) specifically made to suit your needs may also be prescribed.

Text reproduced with permission from the Australasian Podiatry Council