Heel pain is most often experienced in two distinct regions; discomfort is noticed either directly under the heel or just behind it. Heel pain usually comes on gradually; patients may experience heel pain after wearing flat-soled shoes, such as sandals. Some people will have heel pain early in the morning as they first begin walking, then again late in the day as they wind down. In other cases, pain is sudden and is brought on by trauma to the heel bone. Pain is concentrated under or near the heel bone. With foot pain, discomfort is often spread throughout the foot.
Heel pain can develop in many different ways. Plantar fasciitis and Achilles tendonitis are both inflammatory conditions that can lead to heel pain. Some patients develop bursitis, which is an inflammation of the bursa at the back of the heel that is caused by wearing ill-fitting shoes. Severe heel pain can be brought on by a stress fracture or a rupture of the Achilles tendon. Another cause is tarsal tunnel syndrome, in which a nerve in the heel becomes compressed. Many patients experience heel pain as a result of repetitive stresses to the heel that comes from playing sports or engaging in frequent exercise.
Treatment begins with a comprehensive diagnostic evaluation. Dr. Shazia Amar will discuss the patient’s symptoms and lifestyle habits and will examine the affected area to help determine the cause of discomfort. Next, a customized treatment plan will be designed. Some patients will need physical therapy, while others may need a steroid injection to help relieve pain. Often, patients are able to participate in their own recovery from heel pain. Special insoles and orthotics can be worn to prevent continued discomfort and to correct the positioning of the foot while wearing shoes. Fortunately, very few patients require surgical interventions to find relief from heel pain.