Heel pain is one of the most common conditions to affect the foot. It is usually felt as an intense pain when the affected heel is used. The pain is usually worse when you get out of bed in the
morning or after a long period of activity. In most cases, only one heel is affected. After walking, the pain usually improves. However, it is common for it to be painful when you first take a step
after a period of rest. The pain often worsens by the end of the day. Most cases of Heel Pain
are caused by damage and thickening of the plantar fascia. Sometimes, the surrounding tissue and the heel bone also become inflamed (swollen).
The two major causes of heel pain are plantar fasciitis and achilles tendinitis. The easiest way to figure out which one is causing your pain is by location. Generally speaking, if the pain is under
your heel bone it is likely plantar fasciitis. If the pain is found at the back of the heel, in the achilles or toward the base of the achilles (the long cord that extends from your calf to your heel
bone), then it is likely achilles tendinitis.
The primary symptom is pain in the heel area that varies in severity and location. The pain is commonly intense when getting out of bed or a chair. The pain often lessens when walking.
Your doctor will perform a physical exam and ask questions about your medical history and symptoms, such as have you had this type of heel pain before? When did your pain begin? Do you have pain upon
your first steps in the morning or after your first steps after rest? Is the pain dull and aching or sharp and stabbing? Is it worse after exercise? Is it worse when standing? Did you fall or twist
your ankle recently? Are you a runner? If so, how far and how often do you run? Do you walk or stand for long periods of time? What kind of shoes do you wear? Do you have any other symptoms? Your
doctor may order a foot x-ray. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot. Your doctor may recommend a night splint to help stretch your foot.
Surgery may be recommended in some cases.
Non Surgical Treatment
If you have experienced painful heels try wearing your shoes around your house in the evening. Don't wear slippers or socks or go barefoot. You may also try gentle calf stretches for 20 to 30 seconds
on each leg. This is best done barefoot, leaning forward towards a wall with one foot forward and one foot back. If the pain persists longer than one month, you should visit a podiatrist for
evaluation and treatment. Your feet should not hurt, and professional podiatric care may be required to help relieve your discomfort. If you have not exercised in a long time, consult your podiatric
physician before starting a new exercise program. Begin an exercise program slowly. Don't go too far or too fast. Purchase and maintain good shoes and replace them regularly. Stretch each foot and
achilles tendon before and after exercise. Avoid uneven walking surfaces or stepping on rocks as much as possible. Avoid going barefoot on hard surfaces. Vary the incline on a treadmill during
exercise. Nobody walks uphill all the time. If it hurts, stop. Don't try to "work through the pain." Your podiatric physician/surgeon has been trained specifically and extensively in the diagnosis
and treatment of all manner of foot conditions. This training encompasses all of the intricately related systems and structures of the foot and lower leg including neurological, circulatory, skin,
and the musculoskeletal system, which includes bones, joints, ligaments, tendons, muscles, and nerves.
Surgery to correct heel pain is generally only recommended if orthotic treatment has failed. There are some exceptions to this course of treatment and it is up to you and your doctor to determine the
most appropriate course of treatment. Following surgical treatment to correct heel pain the patient will generally have to continue the use of orthotics. The surgery does not correct the cause of the
heel pain. The surgery will eliminate the pain but the process that caused the pain will continue without the use of orthotics. If orthotics have been prescribed prior to surgery they generally do
not have to be remade.
You can reduce the risk of heel pain in many ways, including. Wear shoes that fit you properly with a firm fastening, such as laces. Choose shoes with shock-absorbent soles and supportive heels.
Repair or throw out any shoes that have worn heels. Always warm up and cool down when exercising or playing sport, include plenty of slow, sustained stretches. If necessary, your podiatrist will show
you how to tape or strap your feet to help support the muscles and ligaments. Shoe inserts (orthoses) professionally fitted by your podiatrist can help support your feet in the long term.