Heel Pain
Every day, millions of Americans are greeting in the morning by intense heel pain. As a matter of fact, more than half of the population will suffer from significant heel pain at least once in their lives. We’re not talking about ordinary aches and pains here, but shooting, stabbing, even knife-like sensations that linger and persist for days and weeks.
Although heel pain is extremely common, it is not a normal part of life. Your feet are designed to provide a lifetime of locomotion, and when heel pain gets in the way of daily living, you need to see an expert who can help you heal.
Causes of Heel Pain
Heel pain is not caused by a single condition, and usually can’t be traced to a single incident or injury. More likely, your heel pain is the result of multiple small traumas over time. Each step can place a force on heels equal to anywhere from one and a half to three times your own body weight. Days, weeks, even years of wear and tear from physically demanding occupations, athletic participation, and other activities will slowly build the pain and pressure.
This is the most common form of heel pain in adults. The most notable symptom is heel pain that feels worst with the first few steps of the morning, but gradually recedes over the next 10-15 minutes.
It is caused by stretching, tearing, and inflammation of the plantar fascia, a long ligament on the bottom of the foot that runs from the back of the heel to the ball of the foot. When the fascia is inflamed, it tightens and shrinks, pulling uncomfortably on the heel. (This may further cause a hook-shaped bony deformity known as a spur to form on the heel bone, though heel spurs are usually painless.)
You’ve probably heard of carpal tunnel syndrome of the hands and wrists. Tarsal tunnel syndrome is a similar condition involving the feet and ankles. There is a narrow, constricted space called the tarsal tunnel that must pass though the ankle, and this tunnel surrounds a major nerve. If the nerve becomes compressed, it can cause pain and tingling throughout the foot, but especially so in the heel. Unfortunately, it is often misdiagnosed as plantar fasciitis, which delays successful treatment.
We can treat the condition endoscopically, which means a quicker recovery than through other means.
Other Heel Pain Conditions
Some other conditions we treat frequently include:
This is the most common form of heel pain in adults. The most notable symptom is heel pain that feels worst with the first few steps of the morning, but gradually recedes over the next 10-15 minutes.
It is caused by stretching, tearing, and inflammation of the plantar fascia, a long ligament on the bottom of the foot that runs from the back of the heel to the ball of the foot. When the fascia is inflamed, it tightens and shrinks, pulling uncomfortably on the heel. (This may further cause a hook-shaped bony deformity known as a spur to form on the heel bone, though heel spurs are usually painless.)
Commonly associated with the knees and shoulders, but can also occur behind the heel. There, a bursae sac acts as a cushion between muscles, tendons and bone. An irritated bursae often presents symptoms very similar to Achilles tendintis.
Also known as “pump bump,” this condition creates an enlarged, bony bump at the back of the heel bone. It is especially common among young women and teenagers who wear high heels or other hard-backed shoes frequently. Surgery may be required if the bump is large enough.
When kids get heel pain, the cause is usually inflammation in the growth plates of the heel. This is likely to happen to kids who play a lot of sports and are going through a growth spurt. The constant pressure of activity combined with rapid bone growth makes their heels especially vulnerable.
Heel Pain Treatment Options
The good news is that, 9 out of 10 times, conservative treatments like icing, stretching, and custom orthotics will help you ease the pain of plantar fasciitis, along with most other forms of heel pain. For tougher pain, we may prescribe more aggressive treatments, including:
- Cortisone injections, which provide stronger pain relief to the aching tissues than over-the-counter medications.
- Shockwave therapy. This advanced technology uses high-intensity pressure waves to stimulate injured tissues, which reduces pain felt by nerve fibers, increases circulation, and triggers stem cells to accelerate the healing process.
- Cold laser therapy. The laser emits a beam of light tuned to a highly precise wavelength and intensity. At this frequency, the laser is able to penetrate deep into soft tissues to fight inflammation, improve blood flow, remove waste products, reduce pain, and stimulate tissue repair.
- For most heel pain conditions, surgery is a last resort that is only rarely required, for the most severe cases. The exception is tarsal tunnel syndrome, which is usually best treated with a decompression surgery.
It is critical to understand that not all heel pain is created equal. Even if the symptoms seem the same, the causes may be very different. Each case needs to be fully evaluated by an expert in order to ensure you get the most effective treatment.
