There are several causes for heel pain, they vary from changes in the shape of the foot or the way someone treads, overweight, spur in the heel, a stroke in the foot, to more severe causes like inflammatory diseases such as plantar fasciitis, bursitis or gout, for example, which can both cause constant pain or hurt only when walking and can arise in one or both feet.
To relieve pain, it is recommended you see a orthopedist and physiotherapist, both can identify the cause, and indicate appropriate treatments. These treatments might be the use of anti-inflammatory medicines, foot orthoses, rest and physiotherapy techniques to correct posture, stretching exercises and joint strengthening.
Below are some common causes of heel pain and what to do in each case:
1. Biomechanical Changes
Changes in the shape of the foot or in the way of walking, whether born with a person or acquired throughout life, such as flat feet, in addition to varicose veins or valgus are important causes of heel pain. The pain arises because, these modifications prevent the food from having a good support on the ground, which usually overloads some joint or bone that should not.
- What to do: In some cases, posture correction exercises, the use of feet orthoses and insoles, or even surgery, may be recommended. However, it is important to be followed by an orthopedist and a physiotherapist, so that the changes verified and be evaluated and determined what is the best treatment plan and what additional adjustments must be made.
Pumps women usually wear often cause a momentary "deformity" in the biomechanics of the feet, which can compromise the tendon and calf muscle, which also causes heel pain.
2. Plantar fasciitis
Plantar fasciitis is an inflammation of the tissue that covers the entire sole of the foot. It is usually caused by repetitive traumas or lesions in the plantar fascia, which is a fibrous and firm band that supports and maintains the plantar arch, leading to a local inflammation.
Some of its major causes include having heel spurs, standing for long periods of time, being overweight, having flat feet, and excessive physical activity. This inflammation usually causes pain under the heel, which worsens in the morning when starting to walk, but improves after the first steps and, in addition, can cause local swelling and difficulty walking or wearing shoes.
- What to do: stretching of the calf and sole of the foot, strengthening exercises, deep rubbing massage, infiltration with corticosteroids, insole footwear, radio frequency at the site of pain, and sleep splints are treatment modalities that may be indicated. Some exercises include wringing a towel spread on the floor and picking up a marble.
3. Heel Spur
It is a small fibrous projection that forms in the heel bone, and results from intense pressure and overload on the sole of the foot for long periods of time, so it is more common in people over 40, overweight people, use of inappropriate footwear, foot deformities or runners, for example.
Those who have spurs may have pain when they get up or walk, being common in the morning. In addition, it is very common that the spur is associated with the formation of plantar fasciitis, since the inflammation can extend to nearby structures.
- What to do: Spur treatment is usually done when there is local inflammation, especially when in conjunction with plantar fasciitis. With medical supervision it is recommended the use of ice, resting and anti-inflammatory drugs. These measures are usually sufficient. Surgery is rarely necessary to remove the spur, but in some cases may be the course of treatment.
4. Heel bursitis
The bursa is a small pocket that serves as a shock absorbed, which is located between the heel bone and the Achilles tendon. When there is inflammation, pain is felt in the back of the heel, which worsens when there is movement of the foot. This inflammation usually occurs in people who exercise or in athletes after a sprain or injury but can also happen due to the Haglund deformity that occurs when there is a bone prominence in the upper part of the heel, causing pain in the back of the heel near the Achilles tendon.
- What to do: You may need to take anti-inflammatory drugs, use ice packs, decrease workouts, use of physiotherapy equipment, stretches, and exercises.
5. Sever's Disease
Sever's disease is characterized by pain in the region of the heel bone growth plate that affects children who practice impact exercises such as running, jumping, artistic gymnastics, and dancers who dance with a lot of jumps with their toes.
- What to do: you should reduce the intensity of the training and jumps to avoid its aggravation, in addition it is possible to put some ice cubes rolled in a napkin for 20 minutes and use heel orthoses to support the heel While wearing shoes and it is not recommended to walk barefoot. Always start a workout with a 10 minute walk.
Heel trauma, caused by a blow, a jump, during a run or due to wear and tear of the shoes, can cause pain in the area, which can last for several days, as injuries can occur to the skin, muscles and bones of the area.
- What to do: It is recommended rest, which varies according to the intensity of the injury, but can be between 2 days to 1 week. If the pain persists, an evaluation by the orthopedist is necessary to see if there are more serious injuries, and the need for anti-inflammatory drugs or immobilization of the area.
A good tip to recover faster is to apply cold water patches, which decrease inflammation and swelling, and choose comfortable shoes.
Gout, or gouty arthritis, is an inflammatory disease caused by excess uric acid in the blood, which can accumulate in the joint and cause inflammation and intense pain. Although it is most common in the big toe, gout can also arise to the heel, since the feet are the main areas for uric acid buildup.
- What to do: The treatment for gout attacks has to be done through medical orientation, and usually involves anti-inflammatory drugs, such as Ibuprofen or Naproxen, for example. It is also necessary to be followed by a rheumatologists, who can also prescribe medication to control uric acid levels in the blood, preventing further crisis and complications.
How to know the cause of my pain
The best way to know the cause of the heel pain is to try to find the exact location of the pain and to identify the cause, such as having increased physical activity, having started a new sport, or being hit in that area or something of the sort. Placing a cold path on the affected area may relieve symptoms as well as soaking your feet in a bowl of warm water.
If the pain persists for more than 1 week you should go to the orthopedist or physiotherapist so that the cause can be identified and treatment initiated.