Heel Serious Pain The Causes, Signs And Treatment Options

Overview

Feet Pain

The most common cause of Heel Pain is inflammation due to injury of the soft tissue around your heel. The plantar fascia is the area of your foot most likely to be inflamed, which results in plantar fasciitis. With plantar fasciitis, you experience a sharp burning or stabbing sensation upon arising after walking or standing for prolonged periods. Your first steps each morning probably hurt, too. Heel pain is occasionally caused by excessive pounding on the heels. This is more common in the elderly and overweight individuals whose heel fat pads no longer function properly. Watch for a bruising sensation under the heel when standing and walking. If you think this is your issue, an insert with an artificial fat pad might help alleviate your discomfort. Heel pain is by far the most common foot complaint. There are many medical conditions that are associated with heel pain, including gout and other forms of arthritis.

Causes

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 maybe aggravated by shoes that lack appropriate support and by the chronic irritation that sometimes accompanies an athletic lifestyle. Achilles Tendinopathy, Pain and inflammation of the tendon at the back of the heel that connects the calf muscle to the foot. Sever?s, Often found in children between the ages of 8 - 13 years and is an inflammation of the calcaneal epiphyseal plate (growth plate) in the back of the heel. Bursitis. An inflamed bursa is a small irritated sack of fluid at the back of the heel. Other types of heel pain include soft tissue growths, Haglunds deformity (bone enlargement at the back of the heel), bruises or stress fractures and possible nerve entrapment.

Symptoms

Symptoms may also include swelling that is quite tender to the touch. Standing, walking and constrictive shoe wear typically aggravate symptoms. Many patients with this problem are middle-aged and may be slightly overweight. Another group of patients who suffer from this condition are young, active runners.

Diagnosis

The diagnosis of heel pain and heel spurs is made by a through history of the course of the condition and by physical exam. Weight bearing x-rays are useful in determining if a heel spur is present and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors or evidence of soft tissue damage caused by certain connective tissue disorders.

Non Surgical Treatment

Calf stretch, Heel cups/lifts, ice, night splint, physical therapy, activity modification. Sometimes immobilization in a cast or boot may be necessary. Topical creams, such as Voltaren or Ketoprofen, have been found to have some benefit. In some cases, the tendon may become degenerative (tendonosis). In these instances, treatment is more difficult. Prolonged periods of immobilization and physical therapy may be required. In resistant cases, surgical debridement of the tendon may be necessary. Rarely does a symptomatic achilles tendon rupture. Most achilles ruptures are not associated with prodromal symptoms. Achilles ruptures are more common in men and "weekend warriors," ie middle aged men who like to play sports (soccer, softball, basketball) on the weekends.

Surgical Treatment

It is rare to need an operation for heel pain. It would only be offered if all simpler treatments have failed and, in particular, you are a reasonable weight for your height and the stresses on your heel cannot be improved by modifying your activities or footwear. The aim of an operation is to release part of the plantar fascia from the heel bone and reduce the tension in it. Many surgeons would also explore and free the small nerves on the inner side of your heel as these are sometimes trapped by bands of tight tissue. This sort of surgery can be done through a cut about 3cm long on the inner side of your heel. Recently there has been a lot of interest in doing the operation by keyhole surgery, but this has not yet been proven to be effective and safe. Most people who have an operation are better afterwards, but it can take months to get the benefit of the operation and the wound can take a while to heal fully. Tingling or numbness on the side of the heel may occur after operation.

Prevention

Feet Pain

It may not be possible to prevent all cases of heel pain. However, there are some easy steps that you can take to avoid injury to the heel and prevent pain. Whenever possible, you should wear shoes that fit properly and support the foot, wear the right shoes for physical activity, stretch your muscles before exercising, pace yourself during physical activity, maintain a healthy diet, rest when you feel tired or when your muscles ache, maintain a healthy weight.