It’s a busy, busy life, and that means you’re likely to spend most of your time on your feet. But pounding the pavement can come to a sudden halt when you feel sharp stings of pain pulsating through your heels.
Your heel is the one area of your foot that holds the entire weight of your body and this what makes the main all the more excruciating. For this reason, the simplest of everyday tasks like walking to the store or doing housework becomes extremely difficult, if not prohibitive. This explains why people are willing to spend hundreds and thousands of dollars trying to find an effective cure, which is possible only when you know what is causing the pain in the first place.
Here are 5 common conditions that could be the offenders.
1. Plantar Fasciitis
About the condition: One of the most common causes of heel pain, plantar fasciitis is characterized by pain and degeneration of the plantar fascia. This is a thin, flat expanse of tissue that links the heel to the rest of the foot and also supports the arch of the foot in place. Degeneration of the plantar fascia can cause it to weaken, which in turn, causes the heel of your foot to hurt.
Symptoms: Plantar fasciitis causes stabbing pains that are usually the worst after long periods of rest (when the foot has remained immobile for a long time). For this reason, this condition can make it extremely difficult to take your first steps in the morning after you wake up. It is also very likely to cause pain after prolonged stretches of physical activity. Plantar fasciitis also causes constant pain most of the time since the heel is constantly at the receiving end of stress and load.
Treatment: The first thing to do upon experiencing sudden, prolonged, or intense discomfort in your heel is to seek the guidance of a medical professional immediately. Most foot problems get worse by the day if left unchecked, which is why getting an accurate diagnosis and taking the necessary steps to mitigate the pain should be a top priority.
Your doctor will prescribe you some anti-inflammatory drugs for immediate relief. He will also advise you to walk and practice some stretches regularly and may even recommend wearing orthoses to add support. You may also be asked to re-evaluate your footwear because that could also exacerbate the condition. Patients are also often encouraged to stretch regularly, wear orthoses like Nice Stretch, and to evaluate whether their footwear could be exacerbating the issue.
2. Heel Spurs
About the condition: In layman terms, heel spurs are calcium deposits that cause bony protrusions or spurs on the underside of the heel bone. They are also called “calcaneal spurs” or “osteophytes” and they are usually hooked or pointed in appearance.
Orthopaedics believe that heel spurs form in conjunction with plantar fasciitis and that, it is the body’s way of attempting to correct the alignment of the loose or misaligned plantar fascia ligament that spans the arch of the foot. Is it thought that when the biomechanics of the plantar fascia ligament get imbalanced, the calcium protrusions start forming to support the damaged tissue.
Like plantar fasciitis, heel spurs can occur from walking with an irregular gait or participating in prolonged periods of strenuous physical exercise without getting adequate rest.
Symptoms: Heel spurs do not sense pain. However, they can trigger painful sensations by poking into the fatty tissue padding at the bottom of the heel every time you take a step. Sharp, prodding sensations of pain at the bottom of the heel is the first sign of heel spurs. The pain may range from mild to severe, and according to recent studies, the intensity of the sensation is proportional to the size of the spur.1
Treatment: Rest is extremely important for a speedy recovery, as is the use of orthotic shoe inserts, designed specifically to realign the loose plantar fascia ligament and allow the heel spurs to heal. In extreme cases, surgery may be recommended, but this is more of an exception rather than a rule.
3. Stress Fractures
About the condition: Stress fractures occur when your feet have been subjected to repetitive stress from strenuous physical exercise or sports. As a result, athletes and runners are highly susceptible to stress fractures. However, if you have abnormal bone or renal failure, it is possible to develop stress fractures during completely normal activities as well.
Symptoms: Stress fractures usually exhibit symptoms such as difficulty in placing weight on your heels and pain whenever the fractured bone is compressed. In the early stages, stress fractures will hurt only during activity. Once the fracture matures, it will cause pain before, during, and after activity.
Treatment: Long periods of rest and activity modification until the bone heals are some common treatment methods for this condition. In extreme situations, the physician may even choose to immobilize the area either partially or completely, to ensure the foot has an opportunity to repair itself.
4. Achilles Tendinitis
About the condition: Another condition caused by putting your feet through chronic strain, Achilles tendinitis affects the Achilles tendon, a band of tissue that connects the heel to the lower part of the leg. If the tendon is continually put under stress, it can, over time, become inflamed and painful. Because this is the part of the body that controls the act of lifting your heel when you walk, the condition makes walking a painfully tedious task.
Symptoms: This condition typically exhibits symptoms like an aching pain along the back of the lower leg and right above the heel. As in the case of plantar fasciitis, pain gets worse when you wake up in the morning and after exercise.
Sometimes, the pain in your calf muscle can become unbearable, a symptom often associated with a torn Achilles tendon. In this case, you must seek immediate medical attention.
Treatment: The treatment regime for Achilles tendinitis will include anti-inflammatory drugs to help combat the inflammation. Your doctor may also recommend physical therapy, massage therapy, ice or heat therapy, and immobilization in order to prevent further injury and promote faster healing.
5. Heel Bursitis
About the condition: Heel bursitis is the inflammation of a fluid-filled sac called “bursa” that acts like a cushion and a lubricant between tendons or muscles that slide over a bone. There are two common types of heel bursitis:
- Retrocalcaneal heel bursitis: this is the inflammation of the retrocalcaneal bursa, which is located behind the calcaneal bone, also known as the heel bone.
- Retroachilles heel bursitis: this is the inflammation of the retroachilles bursa, which is located between the Achilles tendon and the skin at the back of the heel. This condition is almost exclusively associated with wearing shoes that dig into the back of the heel.
Both retrocalcaneal and retroachilles can occur at the same time and this can make it even difficult to treat heel pain. While Achilles tendon-related problems can cause bursitis, especially if there is repeated irritation and stretching of the tendon, bursitis can also occur with a completely normal tendon as well.
Symptoms: As mentioned earlier, repeated use and involvement of the ankle in intense activity can cause the bursa to become irritated and inflamed. Pain or discomfort in the heel region during physical activity like walking, jogging or running is also another common symptom.
Note: The Achilles tendon is also connected to pack of the heel where the pain becomes concentrated if the tendon is put through too much stress. Because of the similarity in the symptoms and the area of the inflammation, heel bursitis is very often confused with a problem in the Achilles tendon.
Treatment: Besides adequate rest, your doctor will also prescribe you non-steroidal painkillers and anti-inflammatory drugs to help you deal with the pain and bring down the swelling. Surgery may be advised, though this is only for extreme cases.
|↑1||Kuyucu, Ersin, Figen Koçyiğit, and Mehmet Erdil. “The association of calcaneal spur length and clinical and functional parameters in plantar fasciitis.” International Journal of Surgery 21 (2015): 28-31.|