Heel Problems

Overview and Facts about Heel Problems

Heel problems typically begin with heel pain. It is a common orthopaedic condition that usually occurs under or just behind the heel, where the heel bone and the Achilles tendon connect.

Occasionally, it may also affect the side of the heel. This type of foot condition is known as plantar fasciitis and is the most common cause of pain in the heel.

Pain behind the heel is known as Achilles tendonitis. This can also affect the ankle and the sides of the foot.

Signs and Symptoms of Heel Problems

Symptoms will vary depending on the type of heel problem. These problems and their symptoms are:

• Plantar fasciitis, which involves inflammation of the ligament that runs from the heel bone to the tip of the foot. Pain is felt at the back of or beneath the heel.
• Heel bursitis, which is marked by inflammation in the back of the heel. Pain is felt at the back of or deep inside the heel.
• Heel bumps, which involve swelling at the back of the heel that causes pain around the heel bone. This is most common in teenagers.
• Tarsal tunnel syndrome, in which pain is caused by a pinched tarsal nerve under and behind the heel and in the ankle.
• Chronic inflammation of the heel pad, where an inflamed heel pad causes pain beneath the heel.
• Achilles tendinosis, which is a chronic condition caused by inflammation of the Achilles tendon. It results in pain in the back and underside of the heel.

Causes and Risk Factors of Heel Problems

Heel problems are not usually caused by an injury but rather by repeated stress to the heel. Common causes of heel pain include:

• Repetitive strain to the heel
• Landing hard or awkwardly on the heel
• Pressure-form footwear
• Having flat feet
• A pinched tarsal nerve
• Heavy footsteps
• Worn heel pad
• A ruptured Achilles tendon
• Rheumatoid arthritis

Tests and Diagnosis of Heel Problems

Your doctor will take your medical history and perform a physical examination of the affected foot to see if movement and flexibility are affected and to look for swelling or tissue masses.

They may recommend an X-ray to see if there is any damage to the bone and may also test for nerve damage. Your doctor may also take a blood test or a sample of fluid from the joint to test for conditions such as rheumatoid arthritis.

Treatment and Care for Heel Problems

Depending on the type of heel problem, treatment can take up to several months to provide relief. Treatment options include:

• Non-steroidal anti-inflammatory drugs (NSAIDs), to reduce inflammation and pain.
• Physical therapy, which can help to stretch the tendon in cases of Achilles tendonitis and plantar fasciitis.
• Athletic taping, to provide extra support.
• Orthotics, to help correct faults, such as flat feet.
• Night splints, which can be worn while sleeping to help stretch the tendon.

Surgery, if all else fails, to detach the plantar fascia (the ligament connecting the heel bone to the toes) from the heel bone. However, this may weaken the foot’s arch.