Heel pain is one of the most common reasons we see people in our office. It can happen to you whether you are young or old, run marathons or sit at a desk all day. There are many reasons your heels hurt, but we can get to the bottom of your trouble and find a way to relieve the pain. Let’s look at some of the more common reasons for your sore feet.
Although most of the problems with the plantar fascia—the band of tissue along the sole of your foot that supports your arch—don’t involve inflammation, the term fasciitis (“itis” refers to inflammation) has stuck for this sharp pain under your heel. It is an overuse injury, which means it is brought on by repeated trauma over time.
The problem is deterioration in this strong ligament which impacts the way it functions. When it is damaged, the tissue doesn’t expand and contract properly. While you are at rest (asleep or sitting for a long period), the tissue contracts and tightens up. When you first put weight on it again, it can’t relax as it should to absorb your weight, but pulls against the heel bone, causing a stabbing pain under your heel. Sometimes bone spurs form on the heel bone where the fascia is attached.
After you move about a bit and the fascia limbers up, the pain disappears, only to come back again after the next period of inactivity. This gradually gets worse as time goes on, until you are unable to walk for any distance without pain.
Fortunately, conservative treatment is effective for this problem. This could include rest from activity, stretching, night splints, anti-inflammatory medication, orthoses to correct any biomechanical factors, or possibly cortisone injections for pain. Rarely is it necessary to use more invasive treatments like surgery or ESWT (extracorporeal shockwave therapy).
If the pain is behind your ankle just above the heel, an injury or inflammation of the Achilles tendon may be to blame. This strong tissue band connects your heel bone to your calf muscles and moves your foot up and down, so it can also be damaged from overuse. The pain is usually worse after activity, and goes away with rest. If the tendon is completely torn during an injury, it may require surgery for complete healing.
You can think of the plantar fascia, heel bone, and Achilles tendon as a continuous unit, so problems in one area can affect the others as well. That means remedies such as stretching the calf muscles can help both situations too.
Other Reasons for Heel Pain
Your discomfort could be due to a number of other problems, such as:
- Fracture of the heel bone
- Bruise or contusion (usually from landing on something hard)
- Bursitis (inflamed bursa sac between bone and tendon)
- Rheumatoid arthritis or gout
- Haglund’s deformity or bone growth at the back of the heel
- Sever’s disease – a growth plate problem causing pain in pre-teen and teen years
You won’t know exactly what is wrong unless you come in and have us evaluate your problem. When you have run out of patience with your sore feet and excuses for not doing something about them, contact Far West Podiatric Medical Group in Hawthorne, CA for expert diagnosis and treatment. Patients in the South Bay can reach us by phone at (310) 675-0900 or online by filling out this form.