Heel pain: Causes, symptoms, treatment and prevention

Heel pain 

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1. Do you find it difficult to walk first steps in the morning? 
2. Is your back of the heel aching badly like a killer pain? 
3. Do you feel it painful while standing on flat surfaces for long hours?  
4. Sitting on chairs with hanging legs, do they elevate your pain?
5. Do you feel your muscles of the heel are stiff or tight, especially in the morning or after keeping the legs in same position for long?
6. Do you feel like crying because of the unbearable heel pain?

If you have any of these problems, you are definitely having trouble in your heel and this condition is what makes your life difficult or uneasy.  Even I am also a person with chronic heel pain and I understand exactly how this heel pain feels like. Like a hell, it becomes a source of frustration and irritation.  You end up walking with a limp gait and you can do nothing but tolerate the pain or try out various remedies to get relief from pain. 

In this blog, let us know in detail about these sections:

• What is heel pain?
• What are the common causes of heel pain?
• What are the places in the heel where heel pain can occur?
• Who are the most likely people to get heel pain?
• Are there any risk factors that make you get the heel pain?
• What are the signs and symptoms of heel pain?
• How can heel pain be diagnosed?
• How can heel pain be treated?
• How can we get relief from heel pain?
• What are the home remedies and tips to cure your heel pain?
• How can we prevent ourselves from getting the heel pain?

Heel pain is one of the most common health problem in the people nowadays.  It is more common in the sportsperson but it can develop in anyone.  Heel pain may occur due to different underlying causes or medical conditions.  Our foot is made up of bones, tendons, muscles, ligament and fascia. 

What is heel ? 

The heel is a part of our foot. It is the cushioned part over the calcaneus bone of the foot.  It acts as a shock absorber and protects the surrounding muscles, fascia and ligaments from any injury or pressure.  Our whole body weight comes on heel and it is a natural ability of heel to be able to handle many tons of weight.  But sometimes, the stress over limits and then the heels start to lose their cushioning effect and start paining.  It can cause soreness of the heels. 

Once you feel your heel is sore, try to give rest to your heels. excessive and prolonged use of heels can damage the heel badly and put you in chronic pain. 

Heel pains generally get cured by home care and remedies as well as the non steroidal anti inflammatory drugs available as over the counter medications. 

Heel pain is a common foot problem.  Poor fitting shoes and extra strain on heels by rigorous physical exercise may be the reason for your heel pain. With early diagnosis and treatment, heel pain can be cured. Surgery is rarely required.  Home remedies play an important role in reducing the symptoms of heel pain. 

What are the common causes of heel pain?

Heel pain can be caused by underlying conditions such as:

• Plantar fascitis:  It is the inflammation of the plantar fascia.  It is a band of muscles running from the heel to the base of the toes.  When the plantar fascia is inflamed due to extra strain, sprain or injury, it may cause the complaint of heel pain. In most of the cases of heel pain, the common cause is plantar fascitis.
• Achilles tendinitis: It is the inflammation of the Achilles tendon, a tendon connecting calcaneal bone to the calf muscles. Due to the inflammation of this tendon, the heel pain in the back (retrocalcaneal bursitis)of the foot develops.  It is very severe in the morning.  The person feels sever pain at the back of the heels on walking. 
• Heel spurs:  Spurs are the bony projection,  Sometimes, following plantar fascitis the occurrence of heel spurs is seen commonly.  Heel spurs cause sharp pain that is unbearable and it becomes difficult to walk or carry out activities of daily living without cushioning the heels. 
• Fractures: Some injuries may cause the bones in the foot to break.  Calcaneal fracture or any other microfracture in the nearby areas of heel may cause heel pain.  
• Calcaneal bursitis:  The sac that covers the calcaneal bone or heel bone gets inflammed due to injury. It may also cause heel pain.
• Stress fractures: Overload or overexertion on the heel may cause the fragile bones to break causing stress fracture and develop heel pain in the foot.
• Arthritis: If the person has arthritis, he/she may develop heel pain.
• Sprains and Strains:  Sprain is the twisting of the muscles causing ligament tear and muscle soreness. When the sprains are not treated for long, they may cause heel pain. Excess strain on the heel muscles may also damage the heels causing heel pain.

What are the places in the heel where heel pain can occur?

The spots or places where the heel pain commonly occurs are:

1. Bottom of the heel, the portion where your heel touches the ground
2. Behind or back of the heels, the portion where you can see the round bony projection on the backside of the foot below ankle.
3. Side of the heels, the anterior portion of big toe.
4. Within the heel bone itself, causing sharp pain.

Heel pain may occur simultaneously in both heels. However, it is more common to have heel pain in one foot. 

 

Who are the most likely people to get heel pain?

Heel pain can trouble almost anyone but it is common among some people such as:

• People who stand for prolonged hours
• People who walk barefoot
• People who are overweight
• People who wear high heels such as the actors or models
• People who wear too tight or too loose shoes. If the shoes are too tight, they may put pressure on the muscles and ligaments of the foot. If they are too loose, they may interfere with the walking gait and ultimately cause disturbance in foot mechanics causing heel pain in long run.
• People who wear hard-sole shoes
• People who work for long hours on hard surfaces

What are the risk factors for heel pain?

Heel pain can be caused by following risk factors:

• Heavy physical exercise, too much jumping on hard surfaces, banging the heels 
• Dancing:  too much dancing may put pressure on your heels and may cause heel pain. However a well trained person usually is conditioned to make use of heels wisely while dancing
• Poor fitting shoes.: The most common cause and risk factor is the use of incorrect or poor fitting shoes that can damage your foot and heel causing unbearable foot pain.
• Strains and sprains
• Obesity or overweight adds a lot of weight on to your heels and walking or standing for more hours can naturally tend to cause heel pain in future. 
• occupation such as security guard, housekeeping or professions requiring you to be on your foot for more hours may pose a risk to cause heel pain.

What are the signs and symptoms of heel pain?

The signs and symptoms of heel pain are:

Heel pain itself is a symptom of foot or heel problem but the associated signs and symptoms are as below:

• Early morning stiffness of the heel muscles, especially in the bottom of the foot or sole.
• Severe pain on walking the first step in the morning.  It may lessen on walking for 2-3 minutes.  The pain may be localized to the bottom part of the heel or the back of the heel or even both places in some cases.
• Feeling of sharp corn or stone piercing on placing the foot on hard surfaces or bumps.
• Redness or formation of bump over the back of the heel bone, signalling inflammation of the calcaneal bursa.
• Activity limitation due to severe pain.
• Pain on getting up after sitting for long. 
• Pain on standing for too long. 
• Tenderness to touch 
• Lost muscle strength in the affected area. 
• Presence of bony growth 

How can heel pain be diagnosed? 

You may visit your orthopedic or podiatrist to seek medical care. Podiatrist are the experts in foot care and may evaluate your foot very well.  

The podiatrist may:

•  Do a physical exam of your heel. 
•  Ask you to walk before them to learn how your gait and body mechanics is.
• Examine your gait.  look at your posture of the body while sitting, standing or walking.
• Assess for the tender points or spots of the heel.
• Take your detailed past medical history and any present illness history
• X-rays of the foot may reveal any fracture or bony growth called spurs in your heel.

How can heel pain be treated? What is the cure of heel pain?

Heel pain may last for few weeks to months. The pain symptoms may subside if proper rest is given to the heels and any stress on the heels is avoided.  If untreated, the heel pain becomes a chronic health problem impairing your activity levels. 

Heel pain treatment focuses on reducing the inflammation of the heel and to provide relief from the nasty pain that causes extreme discomfort.

The medical treatment of heel is:

• Pain relief medications, are prescribed
• Analgesic ointments are ordered by the doctor
• NSAIDs are given to reduce inflammation of the heel
• Physical therapy of the foot is recommended: Treatment with ultrasound waves and electrotherapy help in relaxing the muscles of the heel and foot thus reducing the heel pain.
• Several exercises of foot are taught and advised to be done on regular basis such as stretching, rotation of the foot in both directions, rolling foot arch over a soft ball, etc. 
• Ice application using cold packs and cold compress helps to reduce the inflammation and provide instant relief from the pain. 
• Soaking foot in cold water for 5-10 minutes daily two to three times in a day may also heal the inflammation and provide pain relief.
• Some also recommended warm water soaks to treat inflammation.  
• Insoles and specially designed foot wears may be recommended to ease your heel pain.
• Steroid injections may be administered into the heels if the pain gets worse and fails to respond to other treatments.

How do you get rid of the early morning heel pain?

Once you know you have heel pain, the morning pain irritates a lot.  People with heel pain should never get out of bed suddenly in the morning. Try these steps to ease your early morning heel pain.

1. Hold your heel with both hands while still lying on the bed and start massaging the sole of the foot using both the thumbs starting from the toes to downward direction up to the heels.  Do it for 2-3 minutes and repeat at least twice.
2. Now keep your legs down and while lying on the bed, rotate your foot in both directions alternately for at least 3 times. 
3. Stretch the toes towards you and repeat the same for 3 times.
4. Raise your leg and bend it at your knee and using the opposite hand massage the calf muscles.  Do this for 2-3 minutes. Do it at least once. 
5. If your pain is unbearable do not forget to wear the insoles advised by your podiatrist before walking. 
6. Wear your room shoes and walk slowly till your pain subsides. 

What are the home remedies and tips to cure your heel pain?

 Home remedies to treat and cure your heel pain:

• Apply ice to your heels using a cold pack or pads. 
• Soak your feet in cold water for 5-10 minutes or as tolerated 2-3 times a day.
• Do ball exercises by placing the ball under the foot arch and heels and rolling over it many times.
• Sit in the chair and and roll an ice bottle under your soles. Do it as much as you can tolerate. 
• Always apply analgesic ointment before going to bed.
• Wear soft shoes as ordered by your doctor and use insoles if you cant use the same shoes everywhere. 
• Give rest to your heels. 

How can we prevent ourselves from getting the heel pain?

Prevention of heel pain is possible if the mechanical cause of heel pain is avoided. Other medical conditions or injury can not be prevented. However, the common causes are always related to body mechanics and other risk factors. 

• Always wear proper fitting shoes. It must not be too loose or too tight.
• Try to avoid heels if possible if you have recurrent episodes of dull heel pain. 
• Avoid any rigorous or straining exercise that puts a lot of pressure on your heels.
• If you have any underlying medical conditions such as diabetes or arthritis, take your medications regularly as ordered by your doctor.
• Maintain your body mechanics and correct posture while sitting, standing or walking. 
• Avoid putting more pressure on one leg while standing.
• Try to avoid hanging legs for more hours.
• Perform regular stretching and bending exercises to strengthen the muscles of your calf and feet. 
• Keep your heels elevated using a cushion if you start developing mild or dull pain. 
• Always use soft shoes on hard surfaces and avoid standing for long hours on flat or hard surfaces. 

Heel pain is a common foot problem. With early treatment and home remedies such as rest and ice application you can get relief from pain. If still it troubles you a lot, seek prompt medical care and get proper treatment for your heel pain.

Note: This post is for informational and educational purpose only, It is not a substitute to any medical or professional advice or treatment. See your doctor in any case.