Causes of and Treating Heel Pain

Heel pain can be hard to live with, since most people spend at least part of the day on their feet. There can be a number of causes, from injury to strain in the bones, muscles, or tendons of the foot.

Two of the most common sources of heel pain are problems with the Achilles tendon (either tendonitis or a tear) and plantar fasciitis. The Achilles tendon runs along the back of the heel, so if that’s where your pain is located, it could be the source; people often strain it while running, either by running too much or wearing shoes that cut into the heel without providing adequate support. The resulting inflammation leads to pain, which often builds up over time. Rest, ice, and over-the-counter painkillers are usually sufficient to manage this pain. In some cases, the tendon may rupture or tear, which may require surgery to repair.

Plantar fasciitis causes pain under the heel, extending along the bottom of the foot. It’s the result of strain, usually from intense running or jumping; like tendonitis, it often happens when people increase the intensity of their physical activity too quickly, but prolonged standing – especially in unsupportive shoes – can also be the cause. Over-the-counter pain medication and exercises to increase strength and flexibility can help ease the pain, as well as orthotic inserts to cushion and support the foot. If this condition goes untreated, in may develop into a heel spur, a bony deposit on the bottom of the foot. Spurs may not actually cause pain or discomfort, so treatment will depend on if that is the case, however, the treatment is usually the same as plantar fasciitis.

A traumatic injury such as a fall can cause a heel fracture, which is quite painful and will require a cast. Pain medication and keeping pressure off of the heel by using crutches and foot pads can help, too, and you may require physical therapy once you recover.

If you recall stepping on a small or hard object, it’s possible you have a stone bruise: this is a deep bruise penetrating the layer of fat under the heel, and is best treated with rest and ice.

Some combination of rest, ice, and pain medication is usually applied for treating heel pain, while orthotic shoe inserts can help in many cases. Stretching, physical therapy, and splints may be recommended depending on the cause and severity, and in more serious cases, steroid injections or surgery may be needed. Talk to your doctor about the best method.


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