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 worse with the first few steps in the morning or at the initial point of activity. The latter usually gets better with continued activity (squeaky hinge analogy). Walking, running, sprinting,
hill running and jumping will increase the pain. Often, the natural response is to walk on the outside of the foot - in supination - to lessen the stress on the plantar fascia - resulting in new
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
Calf stretch, silicone Heel cups, ice, night splint, physical therapy. Sometimes custom orthotics are beneficial in long standing cases. Steroid injections have been used and although they
temporarily relieve the pain, the pain usually returns within a short period of time. Plantar fasciitis tends to go away in 90% of all people in time. It can take 12-18 months for all the pain to
resolve. If the pain continues after adequate treatment, high frequency shock wave therapy (OssaTron) has been found to be beneficial, unfortunately most insurance companies do not cover this
It is rare to need an operation for heel pain. It would only be offered if all simpler treatments have failed and, in particular, you are a reasonable weight for your height and the stresses on your
heel cannot be improved by modifying your activities or footwear. The aim of an operation is to release part of the plantar fascia from the heel bone and reduce the tension in it. Many surgeons would
also explore and free the small nerves on the inner side of your heel as these are sometimes trapped by bands of tight tissue. This sort of surgery can be done through a cut about 3cm long on the
inner side of your heel. Recently there has been a lot of interest in doing the operation by keyhole surgery, but this has not yet been proven to be effective and safe. Most people who have an
operation are better afterwards, but it can take months to get the benefit of the operation and the wound can take a while to heal fully. Tingling or numbness on the side of the heel may occur after
Preventing heel pain is crucial to avoid pain that can easily interrupt a busy or active lifestyle. Athletes can prevent damage by stretching the foot and calf both before and after an exercise
routine. The plantar fascia ligament can be stretched by using a tennis ball or water bottle and rolling it across the bottom of the foot. With regular stretching, the stretching and flexibility of
tissue through the foot can be significantly improved, helping to prevent damage and injury. Athletes should also ease into new or more difficult routines, allowing the plantar fascia and other
tissue to become accustomed to the added stress and difficulty. Running up hills is also common among athletes in their routines. However, this activity should be reduced since it places an increased
amount of stress on the plantar fascia and increases the risk of plantar fasciitis. Maintaining a healthy weight is also an essential heel pain prevention technique. Obesity brings additional weight
and stress on the heel of the foot, causing damage and pain in the heel as well as in other areas of the foot.