Heel pain is a very common symptom that occurs from overuse or too much stress on the heel. Poor fitting shoes, sudden increase in activity, prolonged standing, being overweight, and tight calf muscles can cause heel pain. In most cases, a sore heel can be treated with rest and modification of factors that may be contributing to your symptoms. Your doctor will discuss symptoms and examine the foot. X-rays are often ordered to look for any bone abnormality in the foot or heel.
Common conditions that can trigger heel pain:
The plantar fascia is a band of fibrous tissue that connects the heel bone to the base of the toes. Inflammation of this tissue can cause stiffness and sharp, aching, or burning pain underneath the heel. Pain may be worse in the morning upon taking your first steps out of bed or after running for prolonged periods. Initial treatment includes ice, anti-inflammatory medication, foot/ankle stretches, and the addition of supportive, cushioning shoes. Sometimes, night splints are used to stretch the fascia allowing it to heal along with heel cups or shoe inserts. A corticosteroid injection (cortisone) into the heel tissue can act as a very potent anti-inflammatory and reduce symptoms as well. Patients with continued pain despite months of conservative treatment may be candidates for surgery. Plantar fasciotomy is a surgical procedure where the heel fascia is cut, allowing the tissue to heal with less tension.
When plantar fasciitis occurs for a long time, calcium deposits can form where the fascia inserts into the bottom of the heel. A bone spur is a hook of bone or calcium deposit that can develop off the heel bone. Bone spurs do not cause pain and many people have bone spurs without any symptoms. However, pain in the presence of a bone spur is usually due to soft tissue irritation and inflammation around the bony protrusion. Treatment of the underlying cause can relieve symptoms. A bone spur on the back of the heel can result from Achilles tendon injury as well. You may notice a bony bump on the back of the heel that rubs against the Achilles tendon and can cause tendinitis, or inflammation of the tendon. The resulting pain can be frustrating if the Achilles tendinitis is not treated.