heel pain

Heel pain, while quite common, can be extremely uncomfortable and painful if not met with proper care or treatment. Heel pain may occur if you injure or overuse the heel. If left uncared for, the affected area may worsen, limiting your mobility and making it difficult to perform everyday activities, such as walking.

There are many different causes of heel pain, including strains or sprains, tarsal tunnel syndrome, stress fractures, Achilles tendinitis, plantar fasciitis, and heel bursitis. One of the most common causes of heel pain for children and teenagers specifically is Sever’s disease. Sever’s disease can develop due to overuse or repetitive microtrauma of the heel bone's growth plates. This condition is often seen among those who are active in sporting activities.

Other causes of heel pain may include issues with poor circulation, poor posture when walking or running, a soft tissue mass, and a rupture of the Achilles tendon.

It is important to find out the cause of the heel pain to help determine the best treatment. 

PLANTAR FASCIITIS

A very common cause of heel pain is plantar fasciitis.  The plantar aspect of your foot is where you plant the foot on the ground.  The plantar fascia is a thick fibrous band that runs along the bottom of your foot from the heel to the toes.  The plantar fascia helps support the arch of the foot.  Plantar fasciitis is an inflammatory condition in and around the heel of your foot that causes strain and small tears in the plantar fascia.  When you stand for long periods of time, walk or run, you can reinjure the plantar fascia.  Usually the heel pain from plantar fasciitis occurs with the first step in the morning and after periods of sitting.  The pain is sharp and shooting, and improves with walking.  The fascia is injured and can heal.  Don’t wait until the pain is constant.  We can help get you back on your feet again!

ACHILLES TENDINITIS

Another common cause of heel pain is Achilles tendinitis.  This heel pain occurs in the back of the heel, and also can be a sharp, shooting pain with the first step in the morning.  The pain can extend up into your calf.  It can sometimes be a burning pain as well.  If you have Achilles tendon pain, don’t wait.  If treated early, we can prevent surgery.  Once the tendinitis progresses, the tendon can tear more or rupture, and surgery may be required. 

TARSAL TUNNEL SYNDROME

Sometimes tarsal tunnel syndrome is the cause of heel pain.  The tarsal tunnel is on the inside of your ankle, and that is where the nerves, blood vessels and tendons travel from the leg across the ankle into the heel.  Tarsal tunnel syndrome is a condition where the nerve inside the tarsal tunnel is compressed and becomes very painful.  The pain is described as burning, sharp, shooting pain, and sometimes there is numbness on the bottom of the foot. 

POSTERIOR TIBIAL TENDINITIS

The posterior tibial tendon is the tendon responsible for holding up the arch.  If the posterior tibial tendon is injured or torn, it can cause heel pain.  This condition is very serious.  When the tendon becomes injured and torn, the arch can collapse and the foot shape can change.  There are four stages of posterior tibial tendon dysfunction.  This is an injury that can heal and improve with treatment. 

STRESS FRACTURES

If the heel bone (calcaneus) is bruised or broken, it can cause heel pain also.  This pain does also occur with the first step in the morning, but typically does not improve with walking.  It is important to have x-rays and an MRI done of your foot if you have constant heel pain, in order to get the proper treatment.  If this is caught early on, we can avoid surgery and get you back on your feet as soon as possible. 

SEVER’S DISEASE (Calcaneal apophysitis)

Sever’s disease is not a disease, it is a heel pain condition in children and teenagers.  This condition is very common with active children, and occurs from running and jumping, resulting in inflammation of the heel and Achilles tendon.  Surgery is not necessary to treat Sever’s disease, however it is important to come in as early as possible to keep your young athlete still in the game. 

HAGLUND’S DEFORMITY (Pump bump)

Some heel pain is caused by a bony proliferation on the back of the heel.  This is caused by the strong Achilles tendon pulling at the bone, and the bone makes more bone.  It is more common in people with high arches and tight Achilles tendons, but can occur in any foot type. 

HEEL SPURS

Heel spurs are not the cause of heel pain.  Frequently patients come in with the diagnosis of a heel spur, and request surgical removal.  Heel spurs are the result of either the plantar fascia or Achilles tendon pulling on the heel bone.  The pain is caused from the plantar fascia or Achilles tendon.  Surgery is not necessary for over 90% of heel spurs. 

HEEL BURSITIS

Bursa sacs are fluid-filled sacs that occur all over the body in an effort to cushion a painful, inflamed or irritated area.  Bursitis is inflammation of a bursal sac.  Sometimes bursitis next to the Achilles tendon is the cause of the pain. 

WHAT CAN BE DONE FOR HEEL PAIN?

It is very important to have the cause of your heel pain determined in order to find the proper treatment.  In our office, we have x-rays, ultrasound and an MRI to help with diagnosing your heel condition.  We also have an MLS cold laser that helps with healing, without surgery.  We offer stem cell injections, that help with healing. We are committed to keep our patients on their feet, or return them to their activities as soon as possible.  We are also devoted to avoiding surgery if possible, however are qualified for reconstructive foot and ankle surgery if that is the necessary treatment.  Don’t wait until your condition worsens.  Call us today and let us help you get back to the life you love.

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