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Heel Pain Explained by a Podiatrist

Heel pain feels random and frustrating, but it usually follows a very predictable pattern. In most cases, heel pain develops gradually, flares during certain activities, and becomes most noticeable in the morning or after sitting. The reason is straightforward. Most heel pain is actually plantar fasciitis. And plantar fasciitis is usually caused by overpronation, which is when your arch collapses more than it should during walking. Once you understand that heel pain and plantar fasciitis are the same condition in the vast majority of cases, the entire problem becomes much easier to solve.

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Articles of Interest

Diagnosing Heel Pain in Adults

Heel pain is a common condition in adults that may cause significant discomfort and disability. A variety of soft tissue, osseous, and systemic disorders can cause heel pain. Narrowing the differential diagnosis begins with a history and physical examination of the lower extremity to pinpoint the anatomic origin of the heel pain. The most common cause of heel pain in adults is plantar fasciitis. Patients with plantar fasciitis report increased heel pain with their first steps in the morning or when they stand up after prolonged sitting. Tenderness at the calcaneal tuberosity usually is apparent on examination and is increased with passive dorsiflexion of the toes. Tendonitis also may cause heel pain

Heel Pain: Common Causes and When to See a Podiatrist

Heel pain often develops from repeated stress or pressure on the foot. One of the most frequent causes is plantar fasciitis, which occurs when the thick band of tissue supporting the arch becomes irritated or inflamed. This condition often causes sharp pain with the first steps in the morning or after long periods of rest. Heel pain can also result from bruising after walking or standing on hard surfaces for extended periods. Over time, excess calcium buildup at the heel bone may contribute to heel spurs, which can irritate surrounding tissues. Achilles tendon problems, including tendonitis, place strain at the back of the heel and often cause pain during activity.

Heel Pain: Diagnosis and Management

The differential diagnosis of heel pain is extensive, but a mechanical etiology is the most common. The specific anatomic location of the pain can help guide diagnosis. The most common diagnosis is plantar fasciitis, which leads to medial plantar heel pain, especially with the first weight-bearing steps after rest. Other causes of plantar heel pain include calcaneal stress fractures (progressively worsening pain after an increase in activity or change to a harder walking surface), nerve entrapment or neuroma (pain accompanied by burning, tingling, or numbness), heel pad syndrome (deep, bruise-like pain in the middle of the heel), and plantar warts. Achilles tendinopathy is a common cause of posterior heel pain; other tendinopathies result in pain localized to the insertion site of the affected tendon.

Resources

4 Common Causes of Heel Pain

Feet are the unsung heroes of the body. They bear your weight and act as shock absorbers so that you can move freely. Heels are put through considerable stress, making it no surprise when pain and other problems strike.

American College of Foot and Ankle Surgeons

Heel pain is one of the most common and persistent foot problems affecting men and women of all ages. It originates deep within the foot, directly on the heel bone, or within the foot’s connective tissue -- the fascia. Pain occurs when tissues become irritated or inflamed resulting in growth of small spurs on the heel bone.

OrthoInfo

Every mile a person walks puts 60 tons of stress on each foot. Feet can handle a heavy load, but too much stress pushes them over their limits. The result is often heel pain — the most common problem affecting the foot.