by Matthew Paden, DPM
Of the 26 bones in the human foot, the heel bone is the largest. While your feet can handle a heavy load, too much stress can push them over their limits. One of the most common places to feel pain is the heel.
Some sore heels can recover on their own given enough rest; however, too often people ignore the early signs of heel pain and keep on doing the activities that caused it. Continuing to use a sore heel can lead to more problems and develop into a chronic condition. Conditions that cause heel pain generally fall into two categories: pain beneath the heel and pain behind the heel.
Plantar fasciitis. Plantar fasciitis is one of the most common causes of heel pain. It is an over use injury. While this condition can exist for fit, active people, overweight individuals suffer from this ailment more often. The condition stems from an increase strain of the ligament (the plantar fascia), the strain results in micro trauma to the fibers where the ligament attaches to the heel bone. Often this trauma becomes a chronic condition secondary to repeat injury. Early signs of plantar fasciitis are pain and stiffness of the heel with the first few steps in the morning.
Heel spur. When plantar fasciitis continues for a long time, a heel spur may form where the fascia tissue band connects to your heel bone. It usually represents a chronic over stretching of tissue that stimulates bone formation in the direction of the pull.
Stone bruise. When you step on a hard object such as a rock or stone, you can bruise the fat pad on the underside of your heel. It may or may not look discolored. The pain goes away gradually with rest.
There are a variety of conditions that cause pain behind the heel. These include inflamed Achilles tendon insertion or an enlargement of the heel bone that is irritated by shoe gear. Achilles tendon injuries occur with over use and with time may produce a spur in the back of your heel.
Accepting persistent pain and a reduction in normal activities should not be your solution to addressing heel pain. If you begin to notice the following symptoms, contact a local podiatrist for an examination:
• Persistent pain in your feet or ankles.
• Increased pain, swelling, redness, tenderness, or heat.
• Foot or ankle symptoms that do not improve after two weeks of treatment with a nonprescription product.
• Heel pain accompanied by a fever, redness (sometimes warmth), or numbness.
• Tingling in the heel; persistent heel pain without putting any weight or pressure on your heel
• Pain that is not alleviated by ice or over-the-counter painkillers (such as aspirin, ibuprofen or acetaminophen)
Heel pain can have many causes. The most important thing is to avoid delaying treatment. A quick examination of your heel can help pinpoint your specific condition and set you on a new path to happier, pain-free feet!
Matthew Paden, DPM, Rocky Mountain Foot & Ankle Center and a surgeon with The Surgery Center at Exempla Lutheran Medical Center.