Heel pain

What is heel pain?

The heel of the foot is prone to many conditions, during walking the heel takes a lot of force with every step that is taken. The heel is made up of many different structures, including the calcaneus (heel bone) which has many tendons and ligament attachments, bursa, and a fat pad on the plantar aspect. In most cases heel pain is contributed from a mechanical cause, other causes include trauma, neurological, arthritis, infections,and autoimmune conditions.

The most common cause of pain in the heel is plantar fasciitis, which is an inflammation of the strong band of tissue which runs across the bottom of the foot, assisting with arch formation. There are many other reasons someone may get pain in the heel.

Other common causes of heel pain are:

• Arthritis
• Fracture
• Heel pad syndrome
• Heel spur
• Bursitis
• Achilles tendonitis
• Tarsal tunnel syndrome
• Puncture wounds
• Bruising

The causes of heel pain may remain unclear, however a number of different factors can contribute to pain such as:

• Change or increase in activity
• Biomechanical factors
• Prolonged use of flat or unsupportive shoes
• Tights calf muscles
• Obesity or recent weight gain
• Sudden injury
• Decrease in fatty padding beneath the heel area with increasing age
• Standing for long periods or on hard surfaces

Can also be associated with inflammatory conditions such as psoriatic arthritis, ankylosing spondylitis and Reiter’s syndrome.

What are the signs and symptoms of heel pain?

Symptoms depend on the conditions causing the discomfort and may include:

• Swelling
• Pain
• Numbness or tingling
• Difficulty to walk
• Difficulty bending to foot downward
• Limping
• Redness
• Increasing discomfort when standing

Some tests may be helpful in ruling out other problems, blood tests may be done for arthritis. X-ray can show cartilage or bone damage on and around the calcaneus.Occasionally an MRI scan may be used for further investigation of bone and soft tissue around the heel.

Benefits of podiatry treatment for heel pain

Heel pain can be assessed during a biomechanical appointment, where a podiatrist carries out specific lower limb assessments, seated, standing, and walking. A thorough medical history will be obtained which is vital in progressing towards a diagnosis. Lifestyle factors also have an important contribution towards the treatment plan outcome. The advice and treatment plan is completely dependent on the diagnoses and the information gained from the assessment, treatments can include the following:

Treatments for heel pain:

• Orthoses
• Immobilisation
• Ultrasound therapy
• Massage
• Taping
• Anti-inflammatories
• Footwear advice
• Insoles
• Advice and education
• R.I.C.E technique
• Steroid injections
• Stretching
• Supportive lace-up footwear
• Night splints
• Physiotherapy

Podiatrist may give advice regarding use of painkillers such as paracetamol or anti-inflammatory medicines to help to reduce pain.

If you have a problem with your foot or lower limb, and you are unsure whether or not podiatry can help you, then why not contact us. If you have any questions or would like to book an appointment then please email us at office@liverpool-podiatry.co.uk or call us on 0151 558 0099.