A medical history and physical exam are usually sufficient to diagnose a skin problem of the heel, although blood tests or a biopsy of the affected area may be needed. Whole-body inflammatory diseases like sarcoidosis , rheumatoid arthritis , or reactive arthritis may cause heel pain.
Oftentimes, other symptoms are present with these systemic diseases, such as fever, rash, and joint pain and inflammation.
Laboratory and imaging studies are also used to diagnose systemic diseases. Treatment depends entirely on the root cause of your heel pain. If you are unsure of your diagnosis, or how severe your condition is, be sure to seek medical advice before beginning any treatment plan. Some common treatments are listed here—but keep in mind, not all of these are appropriate for every condition.
In other instances, resting can help to eliminate the most severe pain until you are able to see your doctor or a podiatrist. For most sources of heel pain, applying an ice pack over the heel for minute intervals up to four times daily can help diminish swelling and soothe your pain. Be sure to place a thin towel between the ice pack and the skin of your heel. Taping the foot with sports tape or hypoallergenic tape is useful for certain heel diagnoses like plantar fasciitis, heel pad bruise, and heel pad syndrome.
For plantar fasciitis, your doctor may recommend a taping technique involving four strips of tape that get applied around the foot and heel. The tape should not be applied too tightly and can stay in place for one week.
What Is It?
Exercises and stretches are designed to relax the tissues that surround the heel bone. Some simple exercises, performed in the morning and evening, often help patients feel better quickly.
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For Achilles tendonitis, your doctor may refer you to a physical therapist who uses a specialized exercise program called the Alfred protocol, which focuses on eccentric loading of your Achilles tendon. Depending on the cause of your heel pain, various foot supports may be recommended by your doctor. For instance, for plantar fasciitis, your doctor may recommend wearing splints at night to keep your foot straight. Likewise, heel wedges or shoe orthotics may be recommended for the treatment of Achilles tendonitis.
For Haglund's syndrome, your doctor may recommend altering the heel height of your shoes. Nonsteroidal anti-inflammatory medications NSAIDs are commonly prescribed for heel pain caused by problems such as plantar fasciitis, Achilles tendonitis, a heel pad bruise, Haglund's syndrome, heel bursitis, heel pad syndrome, and sinus tarsi syndrome. Sometimes, cortisone —a steroid that reduces inflammation—may be injected into the heel to ease the pain temporarily for a few weeks, usually.
While immediate surgery is needed nearly all the time to treat an acute Achilles tendon rupture, for other causes of heel pain, surgery is generally only recommended if non-surgical therapies have not worked for a period of six to 12 months. For example, with plantar fasciitis, surgery to detach the plantar fascia from the heel bone called plantar fascia release may be performed if all other treatments have failed for one year.
The Heel Shoe Fitters
Another surgery called gastrocnemius resection in which the calf gastrocnemius muscles are lengthened may also be performed for persistent plantar fasciitis. Preventing symptoms of heel pain may be a critical component of the long-term treatment of your condition. Depending on the exact source of pain, prevention strategies may slightly differ. But in general, there are some steps that you can take to avoid a recurrence of heel pain symptoms.
Some causes of heel pain are more serious than others. Regardless, your doctor can help you figure out what's causing the discomfort and craft a treatment plan that will help your specific situation. The upside is that most solutions are fairly simple—rest, ice packs, and footwear modifications—that you can do at home without any hassle. Try to follow your doctor's plan as best as you can—your body, including your heel, deserves your attention and care so it can heal properly and you can be pain-free.
Dealing with joint pain can cause major disruptions to your day. Sign up and learn how to better take care of your body. Click below and just hit send! There was an error. Please try again. Thank you, , for signing up. American Academy of Orthopedic Surgeons. Heel Pain. Buchbinder R. Patient education: Heel and foot pain caused by plantar fasciitis Beyond the Basics. Isaac Z, ed. Plantar and medial heel pain: diagnosis and management. J Am Acad Orthop Surg. Piezogenic pedal papules.
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Heel Pain Guide: Causes, Symptoms and Treatment Options
More in Orthopedics. The two most common causes of heel pain are plantar fasciitis and Achilles tendonitis. Plantar Fasciitis. An Overview of Plantar Fasciitis. Achilles Tendonitis. An Overview of Achilles Tendonitis. Tarsal Tunnel Syndrome. Stress Fractures. Other factors that increase a person's chance of developing a stress fracture include:. Low bone mass osteopenia Having an eating disorder, like anorexia or bulimia Experiencing infrequent or absent monthly periods. Heel Pad Bruise.
Fat Pad Atrophy. Haglund's Syndrome With or Without Bursitis. There are two types of heel bursitis:. Sinus Tarsi Syndrome. These heel diagnoses are rare, but worth keeping in the back of your mind:. Piezogenic Papules. Heel Bone Infection. Heel Bone Tumor. A tumor in the heel bone may cause pain, usually reported as deep, boring, and worse at night.
Here are some definite signs that you should be evaluated by a doctor:.
- Heel Pain (Plantar Fasciitis);
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Inability to walk comfortably on the affected side Heel pain that occurs at night or while resting Heel pain that persists beyond a few days Swelling or discoloration of the back of the foot Signs of an infection, including fever, redness, warmth Any other unusual symptoms. Medical History. Where is your pain located? If your pain occurs with weight-bearing activities, do you notice it first thing in the morning after rest as in plantar fasciitis or later in the day after activity as in heel pad syndrome?
Is your heel pain worse at night? Nighttime pain is more common with nerve-related sources of pain, as well as with tumors. Are you experiencing other symptoms besides heel pain, such as fever, numbness, or swelling? Physical Examination. Differential Diagnoses. Nerve Pain. Skin Problems. Systemic Diseases. How to Ice an Injury. Stretches for Plantar Fasciitis Relief. What the Alfredson Protocol Entails. Or you may feel pain deep inside the heel when it makes contact with the ground. Heel pain is a common condition and in most cases will diminish following some routine self-care measures.
If the pain persists longer than three weeks, it is best to seek professional advice from a podiatrist, as there are many types of heel pain, each with their own different causes and separate forms of treatment. If you experience heel pain, some simple self-care measures include:. More specialist treatments include:. In the acute stage, use ice compresses for 10 minutes twice a day, and ibuprofen always check with your GP or pharmacist before taking any new medication. In some cases, padding and strapping is applied to alter the direction of stretch of the ligament to alleviate symptoms in the short term.
However, for the long term, special insoles orthoses may be prescribed to help the feet to function more effectively and help to make any possible recurrence less likely. Heel bursitis calcaneal bursitis :. Medication and ultrasound can give relief but for the long term, a shoe insert may be necessary. In addition, attention to the cause of any rubbing and appropriate padding and strapping will allow inflammation to settle. Adjustments to footwear is usually enough to make them comfortable, although a leather heel counter and wearing boots may help.
Causes of Heel Pain and Treatment Options
In more serious, recurring cases, surgery may be necessary. Tarsal tunnel syndrome:. Special shoe inserts can reduce the pressures on the nerve and may be appropriate for certain foot types whereas, on other occasions, local injections of medication to the area where the tibial nerve is inflamed may be necessary. If this is suspected, an X-ray is required to confirm final diagnosis and to determine the extent of the injury and a follow-on treatment plan. This condition is temporary and self-limiting but can be painful at the time.
Rest and stretching exercises may help. Treatment involves special exercises that strengthen the tendon and increasing the height of the heel with an insole on a temporary basis. Follow the self-care measures above in the first instance. If you experience any foot care issues that do not resolve themselves naturally or through routine foot care within three weeks, it is recommended that you seek the help of a healthcare professional.
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Heel Pain. What is heel pain? What causes the problem? Heel bursitis subcalcaneal bursitis : This is an inflammation of a bursa a fluid-filled fibrous sac under the heel bone where the pain is typically more in the centre of the heel than that experienced with plantar fasciitis and significantly worsens during the day. Heel bumps: These are firm bumps on the back of the heel, usually caused by excessive shoe rubbing in the heel area, or the thickening of the tissues associated with a tight Achilles tendon. Tarsal tunnel syndrome: This can feel like a burning or tingling sensation under the heel within the arch of the foot with occasional loss of sensation on the bottom of the foot.
Chronic inflammation of the heel pad: This is caused by a heavy heel strike or sometimes a reduction in the thickness of the heel pad which can give rise to a dull ache in the heel which increases during the day. Fracture: Often caused following injuries such as falling from a height or landing on an uneven surface.