Heel Pain Treatment Options

Your feet and ankles are a complex network of 26 bones, 33 joints, and innumerable tendons. The heel is the largest bone in your foot’s intricate anatomy.

Overworking or straining your heel could result in serious discomfort. The severity of the anguish may vary, yet if common home treatments have no effect for your heel pain, you should seek a specialist’s diagnosis right away to determine and treat the cause of your pain.

What is heel pain?

Heel discomfort is a standard issue that affects feet and ankles. This ache can be felt near the back of your heel or under it. There are multiple conditions that may result in such pain, such as:

• Plantar fasciitis.
• Bursitis.
• Stress fractures.
• Inflamed tendons.
• Achilles or flexor tendonitis/tendonosis.
• Bone spurs.
• Sever’s disease (mostly in children 8-14 years old).

It is essential to receive a medical examination in order to identify the precise source of your heel pain so that you can begin an appropriate treatment plan.

Heel pain can be a hindrance to your daily life and make it difficult for you to even walk. Thankfully, most painful heel conditions improve with non-surgical treatments–but the body needs adequate time to heal.

Related: Heel Spur: Cause, Symptoms, Treatment, and How to Avoid It

How usual is heel pain?

Annually, approximately 2 million Americans grapple with heel pain – a challenge that knows no bounds in regard to age or gender.

Related article about heel pain.

Where does heel pain occur?

You could encounter any type of soreness or tenderness across your heel. Typically, you notice this pain in the following areas:

• Behind the heel.
• Beneath the heel.
• Within the heel bone itself.

What is the reason for the pain behind the heel?

Heel pain can be triggered by a variety of issues, including:

• Achilles tendinitis: At the back of your heel is the longest and strongest tendon in your body, known as the Achilles tendon. This fibrous tissue connects your calf muscle to its respective bone. Runners and basketball players are particularly susceptible to developing Achilles tendinitis through overuse, which can lead to discomfort, swelling, and stiffness around that area.
• Haglund’s deformity: An incessant and persistent inflammation can result in the development of a bony protrusion at the back of your heel, referred to as a “pump bump”. Sadly enough, shoes featuring higher heels like pumps could make this condition more painful.
• Sever’s disease (calcaneal apophysitis): Heel pain in young, physically active children between 8 and 14 is often caused by Sever’s disease. Kids who engage in sports that involve a lot of running and hopping are particularly likely to suffer from this issue due to the increased athletic activity stressing the growth plate located at the back of their heel.
• Bursitis: Bursitis is a common disorder caused by the inflammation of bursae (plural of bursa) which are tiny sacs that provide fluidity and cushioning to joints. It often manifests with an aching pain in the heel, similar to feeling bruised. Bursitis usually follows long-term standing or walking on hard surfaces.

What is the reason for the pain beneath the heel?

The following issues can cause pain in the heel area:

• Plantar fasciitis: Plantar fasciitis is a painful affliction resulting from the tearing or stretching of the fascia, connective tissue located on the bottom (or plantar surface) of the foot. Those who frequently partake in activities involving running and jumping may be more susceptible to developing this condition. Additionally, surfaces such as concrete or treadmills can serve as irritants that exacerbate pain caused by plantar fasciitis.
• Heel spurs: If you suffer from chronic plantar fasciitis, a bony growth known as a heel spur is likely to develop on the heel bone. While many people do not experience pain due to this condition, some may feel discomfort in their feet.
• Bone bruise (contusion): If you’ve ever stepped on a hard, jagged object and experienced discomfort in your heel, it is most likely due to bruising of the fat padding beneath the back of your foot. Despite not witnessing any discoloration, walking will be quite painful. In addition to this type of injury, stress fractures and Sever’s disease may result in pain along the bottom or sides of your feet too.

What are the risk factors for heel pain?

Heel pain is often caused by activities that place heavy stress and strain on the feet; however, your foot mechanics and structure can also play a role.

The odds are greater that you will experience heel pain if:

• Spend countless hours on your feet, particularly when it comes to concrete floors.
• Wearing shoes that lack proper arch support and cushioning.
• Are struggling with obesity.
• Have foot and ankle arthritis, flat feet, or high foot arches.
• Run or jump a lot.

What are the symptoms of heel pain?

The signs and symptoms of heel pain may vary depending on its origin. Other than the sensation of discomfort, you could experience:

• Swelling.
• Tenderness.
• Pain after standing from a resting/sitting position.
• The bony growth on the heel.
• Discoloration (bruising or redness).
• Stiffness.

What methods are used to detect heel pain?

Your healthcare professional will evaluate your signs and conduct a physical exam. X-rays could also be ordered to analyze for arthritis, bone fractures, correct alignment of bones, as well as any potential damage in the joints.

While uncommon, an MRI or ultrasound may be required to identify any soft tissue issues that X-rays cannot detect.

Related: What is Heel Pain and What Products are best to Relieve it

What difficulties can heel pain cause?

Heel pain can be incapacitating and prevent you from doing the things that make life enjoyable. When it hurts to move, a sedentary lifestyle often follows, leading to weight gain as well as depression due to lack of physical activity. Without treatment for heel pain, your quality of life may significantly diminish.

If left untreated, Achilles tendonitis can weaken your tendons causing them to break down (tendinosis). Over time, this could ultimately lead to a tear or rupture of the Achilles tendon – for which surgery may be required.

What treatments are available to manage or relieve heel pain?

Heel pain can be effectively managed with non-invasive approaches, enabling you to treat the condition without surgery. Common treatments involve decreasing discomfort and irritation along with increasing foot flexibility – all while reducing stress on your heels. Such therapies include:

• Pain relievers: Utilizing both Nonsteroidal anti-inflammatory drugs (NSAIDs) and ice packs can significantly reduce pain and swelling.
• Physical therapy: Massage, physical therapy, and ultrasound treatments are all powerful methods of breaking up soft tissue adhesions that can alleviate pain and reduce inflammation.
• Injections: Steroid injections have been proven to provide relief from both pain and inflammation; they shouldn’t be used as a primary treatment for tendon issues, but are highly successful in managing plantar fasciitis and bursitis.
• Orthotic devices: Rejuvenate your heel by opting for over-the-counter or custom orthotics. Morning pain can be eased with a nightly splint and more severe symptoms may call for a walking boot. Make sure to switch to supportive shoes that are appropriate for both everyday wear and exercise in order to ensure the best results.
• Stretching exercises: With the guidance of your healthcare professional, learn how to perform heel stretching exercises as a means of reducing tightness within your tendons and muscles.
• Taping: You can employ an athletic or medical tape to reinforce your foot arch and heel.

While surgery is often not necessary to alleviate heel pain, it may be an option depending on its cause.

How can I keep my heels healthy and free from pain?

To protect against heel agony or ensure the pain does not return, it is paramount that you maintain flexibility in both your feet and Achilles’s tendons. Regular stretching will help as well as wearing shoes designed specifically to fit and give support. As runners are especially vulnerable to heel aches, decreasing the running mileage with softer surfaces may be beneficial in avoiding injuries altogether.

What can we expect from people suffering from heel pain?

Although heel pain is commonly resolved with non-surgical treatments, it can take some time for your body to heal. Taking a patient and gradual approach will ensure that you don’t delay the healing process by doing too much too soon. If necessary, surgery may be an option in rare cases; however, this should only be considered after consulting with your doctor first.

How can I be certain when it’s time to reach out to my physician?

If you’re experiencing any of the below symptoms, contact your healthcare provider right away:

• If your discomfort persists for several weeks despite rest or taking painkillers.
• Pain that impedes walking and movement.
• Unrelenting swelling, tenderness, and rigidity of the feet or heel.

What key queries should I bring up during my appointment with the doctor?

It’s wise to consult with your healthcare provider and ask the following questions:

• What could be the cause of my heel discomfort?
• What are the most effective treatments for my condition?
• How can I prevent heel pain from recurring?
• When should symptoms be evaluated with a heightened sense of urgency?