Heel Pain

Introduction

The heel is a cushion of fat tissue at the back part of the human foot that protects the structure of muscles, ligaments and the heel bone (calcaneus).Heel pain is a common foot condition, seen in one out of 10 people with at least one episode in their life time. It is essential to make a correct diagnosis of the cause of heel pain so as to direct a person for appropriate treatment.

Causes

Heel pain is often due to tenderness in the heel and can be caused by obesity, abnormal walking style, standing or walking or running on hard surfaces and wearing ill-fitting shoes. Heel pain is rarely caused by injury. The conditions that are related to heel pain are –

  • Plantar fasciitis, inflammation of the ligament that connects the heal bone to the toes
  • Bursitis, swelling of a bursa at the back of the heel
  • Achilles tendinitis, swelling of the Achilles tendon that connects calf muscle and heel
  • Bone spurs in heel
  • Calcaneus fracture, fracture of heel bone
  • Haglund's deformity, bone enlargement at the back of heel
  • Tarsal Tunnel Syndrome, nerve enlargement at the back of the foot
  • Arthritis, swelling of joints

Symptoms

The common symptoms are chronic heel pain mostly during walking, jogging and running. Sharp and stabbing pain when you first stand up early in the morning and stand after sitting for long hours may also occur.

Diagnosis

The cause of the heel pain is diagnosed by studying your medical history. The doctor will examine your heel by observing and feeling for signs of swelling and tenderness. The doctor might perform a diagnostic X-ray if necessary.

Treatment

Treatment of heel pain completely relies on the causes. The conventional treatments are -

  • Rest from activities that causes stress on the heel
  • Applying ice packs to help pain and inflammation
  • Regular exercise and foot massage
  • Wearing proper shoes, heel cups, professional heel straps and night splints

Other treatments include –

  • Ultrasound therapy
  • Anti-inflammatory drugs (topical or oral)
  • Analgesics
  • Surgery may be recommended incases of heel spurs, bursitis and fracture of heel bone.

Prevention

Following are the few steps to avoid heel pain –

  • Wearing proper fitting shoes
  • Reduce weight if you are obese
  • Using shoe inserts

Haglund's deformity

Introduction

The heel is present at the back of the foot below the ankle. It consists of Achilles tendon (a fibrous tissue connecting the calf muscle and the heel) and the bursa (a sac between the tendon and bone containing fluid). Haglund's deformity is a condition in which a bony enlargement is formed in the heel. The soft tissues present at the back of your heel become irritated due to the rubbing of the extra bony growth. This deformity may also be characterized by bursitis (inflammation of the bursa). This condition may develop due to repeated pressure on the back of the heel. Haglund's deformity is also termed as "pump bump" disease.

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  • Medical Protection Society
  • General Medical Council
  • British Orthopadeic Association
  • American Orthopaedic Foot Ankle
  • Bofas