is usually focused on the underside or the back of your heel. If your pain is on the underside of
your heel, its likely cause is plantar fasciitis. Pain on the back of your heel, where the Achilles tendon attaches to the heel bone, is Achilles tendinitis. Although heel pain is rarely a symptom of
a serious condition, it can interfere with your normal activities, particularly exercise.
While heel pain has many causes, it is usually the result of poor biomechanics (abnormalities in the way we walk). This can place too much stress on the heel bone and the soft tissues attached to it.
The stress may result from injury, or a bruise incurred while walking, running or jumping on hard surfaces: wearing poorly constructed footwear or being significantly over weight. Systemic diseases
such as arthritis can also contribute to heel pain.
Usually when a patient comes in they?ll explain that they have severe pain in the heel. It?s usually worse during the first step in the morning when they get out of bed. Many people say if they walk
for a period of time, it gets a little bit better. But if they sit down and get back up, the pain will come back and it?s one of those intermittent come and go types of pain. Heel pain patients will
say it feels like a toothache in the heel area or even into the arch area. A lot of times it will get better with rest and then it will just come right back. So it?s one of those nuisance type things
that just never goes away. The following are common signs of heel pain and plantar fasciitis. Pain that is worse first thing in the morning. Pain that develops after heavy activity or exercise. Pain
that occurs when standing up after sitting for a long period of time. Severe, toothache type of pain in the bottom of the heel.
To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain
other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are
found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
Non Surgical Treatment
Treatment includes resting from the activities that caused the problem, doing certain stretching exercises, using pain medication and wearing open-back shoes. Your doctor may want you to use a 3/8"
or 1/2" heel insert. Stretch your Achilles tendon by leaning forward against a wall with your foot flat on the floor and heel elevated with the insert. Use nonsteroidal anti-inflammatory medications
for pain and swelling. Consider placing ice on the back of the heel to reduce inflammation.
Only a relatively few cases of heel pain require surgery. If required, surgery is usually for the removal of a spur, but also may involve release of the plantar fascia, removal of a bursa, or a
removal of a neuroma or other soft-tissue growth.
You should always wear footwear that is appropriate for your environment and day-to-day activities. Wearing high heels when you go out in the evening is unlikely to be harmful. However, wearing them
all week at work may damage your feet, particularly if your job involves a lot of walking or standing. Ideally, you should wear shoes with laces and a low to moderate heel that supports and cushions
your arches and heels. Avoid wearing shoes with no heels. Do not walk barefoot on hard ground, particularly while on holiday. Many cases of heel pain occur when a person protects their feet for 50
weeks of the year and then suddenly walks barefoot while on holiday. Their feet are not accustomed to the extra pressure, which causes heel pain. If you do a physical activity, such as running or
another form of exercise that places additional strain on your feet, you should replace your sports shoes regularly. Most experts recommend that sports shoes should be replaced after you have done
about 500 miles in them. It is also a good idea to always stretch after exercising, and to make strength and flexibility training a part of your regular exercise routine.