Heel Pain

Heel pain is a very common ailment especially in adults. Pain in heel usually stems from regular daily activities and in some cases, from exercise. The calcaneus (scientific name for heel bone) is the first part of the foot to have contact to the surface during walking, so it is more prone to stress.

As a rule, the arches of the feet flatten and the flexor digitorum brevis muscle maintains the arch and helps stabilize the feet during walking. However, when the structures linked to the heel bones swell because of gait abnormalities, chronic heel pain ensues. In some cases, the muscles strain drags bone away from the calcaneus, causing pain.

 

What are the symptoms of heel pain?

Foot and heel pain are usually more acute after rest. It usually abates with activity, but becomes increasingly severe with extended activity. The inactivity (because of the rest) allows the foot muscles to tighten, and thereby increases strain on the plantar fascia. Inactivity also worsens heel spurs.

 

What causes heel pain?

Regular activities can cause pain in heel over time. Exercises that involve cyclic running or jumping, standing for extended periods (especially on shoes that do not fit well), and other such physical strains can all lead to foot and heel pain.

Conditions such as obesity, achilles tendonitis , ankylosing spondylitis, soft-tissue sarcoma, and stress fractures also contribute to foot heel pain. Bone bruises, pronation, and Haglund's deformity are also culprits.

 

How to diagnose?

The doctor usually asks the patient for a complete history of symptoms before performing a physical examination, usually coupled with imaging exams. The x-rays or MRI scans help detect stress fractures, heel spurs , and calcifications.

 

How to cure heel pain

If heel pain is not too severe as to cause debilitation, conservative forms of treatment may be all that is required. Patients will be asked to stay away from foot activities that could exacerbate the pain, such as standing too long. Ice may also be applied to the area to reduce swelling. In most cases, these simple measures combined with wearing comfortable shoes helps to get rid of foot and heel pain. For more persistent pain, orthotics may help. Special inserts can support the feet more properly and also help align and balance the foot. Doctors may prescribe ibuprofen to alleviate reduce pain.

When the pain becomes debilitating, the doctor may decide to administer injections (corticosteroid) or ionophoresis, which is less painful as it only uses electrical charges to pull medication through the skin. The patient may then be required to wear a splint that helps keep the affected foot at an angle during rest.

A recent noninvasive procedure called extracorporeal shock wave therapy (ESWT) has also been proven effective in treating chronic heel pain. The procedure takes less than an hour, and patients are usually allowed to restart normal foot activity after just one day. However, ESWT cannot treat heel pain caused by infections, by rheumatoid arthritis , or by tarsal tunnel syndrome. It also cannot be used on patients with bleeding disorder and people who regularly take medications such as heparin.

If none of these noninvasive techniques work, the patient may be required to go through conventional surgery. In surgery, the plantar fascia is released, or the bursa or heel spur is removed.