Heel pain is a common condition that affects people of all ages. It can cause discomfort, stiffness, and even difficulty walking. Heel pain may arise from several different causes, each with its own set of symptoms and treatments. The following aims to provide you with information about some of the most common causes of heel pain and how these conditions can be treated.

​

 

1. Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain. It occurs when the plantar fascia, a thick band of tissue that runs along the bottom of your foot, becomes inflamed. This can cause sharp pain in the heel, especially in the morning or after long periods of rest.

Treatment options:

• Stretching exercises for the calf muscles and plantar fascia.

• Orthotics (custom insoles) to support the arch of the foot.

• Ice therapy to reduce inflammation.

• Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief.

• Steroid injection therapy.

• Shockwave Therapy 

 

2. Loss of Fatty Padding

Over time, the fatty padding beneath the heel can thin out, leading to reduced cushioning and increased pressure on the heel bone. This may result in pain, particularly with standing or walking for long periods.

Treatment options:

• Custom orthotics or cushioned insoles to provide additional padding and support.

• Use of cushioned shoes or heel pads.

• Rest and avoiding prolonged standing or walking.

• In severe cases, fat pad grafting surgery may be considered.

 

3. Nerve Entrapments

Nerve entrapments occur when a nerve in the foot or lower leg becomes compressed or irritated. Common types affecting the heel include baxters nerve entrapment and tarsal tunnel syndrome, where the tibial nerve becomes trapped as it passes through the tarsal tunnel near the ankle.

Treatment options:

• Stretching and strengthening exercises to reduce nerve pressure.

• Orthotic devices to correct foot positioning and correct footwear 

• Steroid injections to reduce inflammation around the nerve.

• Surgical options in severe cases.

 

4. Heel Spurs

Heel spurs are bony growths that develop on the underside of the heel bone. While heel spurs themselves may not always be painful, they can cause discomfort when they press against soft tissues in the foot.

Treatment options:

• Rest and avoiding activities that put strain on the heel.

• Orthotic devices to reduce pressure on the heel.

• Stretching exercises and physical therapy.

• Steroid injections to reduce inflammation.

• In rare cases, surgical removal of the spur.

 

5. Achilles Tendinopathy

Achilles tendinopathy refers to inflammation or degeneration of the Achilles tendon, which connects the calf muscles to the heel bone. This condition can cause pain and stiffness at the back of the heel, especially after activity.

Treatment options:​

• Stretching and strengthening exercises to improve flexibility and reduce strain on the tendon.

• Rest and avoiding activities that put strain on the Achilles tendon.

• Eccentric strengthening exercises, which involve lengthening the tendon while it is under load, can be particularly helpful.

• Orthotics to provide better foot positioning and reduce tendon stress.

• In some cases, a corticosteroid injection may be considered.

 

6. Other Causes of Heel Pain

Several other factors can contribute to heel pain, including:

• Bursitis (inflammation of the bursa, a fluid-filled sac near the heel).

• Rheumatoid arthritis or other systemic conditions that cause inflammation in the joints.

• Infections or fractures (less common but may require more specialised treatment).

​

Treatment for heel pain varies depending on the underlying cause. If you are experiencing heel pain that doesn't improve with rest, stretches, or over-the-counter pain medications, it is important to see a podiatrist or healthcare provider. They can help diagnose the cause of your pain and recommend appropriate treatment options for you. 

You should seek advice if:

• Heel pain persists for more than a few weeks.

• You have swelling, redness, or warmth around the heel.

• You are unable to walk or put weight on the affected foot.

• You have a history of diabetes or other health conditions that may affect your feet.

 

Heel pain can be caused by various conditions, each requiring specific treatment. Most cases can be managed effectively with a combination of stretching, exercises, orthotics, and, when necessary, steroid injections or other therapies. Early intervention is key to preventing long-term problems and aiming for recovery.

 

If you're unsure about the cause of your heel pain or if conservative treatments are not helping, please contact your podiatrist or healthcare provider to discuss further options.