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  • Dr Ravi Mohali

Heel pain causes and treatment

Heel pain is a common foot issue. It usually occurs under the heel or just behind it, where the Achilles tendon connects to the heel bone. Sometimes, it can affect the side of the heel. Pain that occurs under the heel is known as plantar fasciitis. This is the most common cause of heel pain. Pain behind the heel is Achilles tendinitis. Pain can also affect the inner or outer side of the heel and foot. In most cases, heel pain resolves without treatment, but sometimes, it can persist and become chronic.


It’s important to have a medical evaluation to help you determine the exact cause of your heel pain so that the proper treatment regimen can begin.

Heel pain can make it difficult to walk and participate in daily activities. Most painful heel conditions improve with nonsurgical treatments, but your body needs time to recover.





Causes

What causes pain behind the heel?

Several problems can cause pain to develop in the back of the heel:

Achilles tendinitis: The Achilles tendon is a fibrous tissue that connects the calf muscle to the heel bone. It’s the body’s longest and strongest tendon. Runners and basketball players are more prone to Achilles tendinitis. This overuse injury inflames the tendon. Tendonitis causes pain, swelling and stiffness in the back of the heel.


Bursitis: Bursitis occurs when fluid-filled sacs called bursae (plural of bursa) swell. These sacs cushion joints, allowing for fluid movement. You may have a tender, bruise-like feeling in the back of the heel. Bursitis typically occurs after you spend a lot of time on your feet.


Haglund’s deformity: Chronic inflammation and irritation can cause an enlarged bony bump (called a pump bump) to form in the back of the heel. Shoes with higher heels, such as pumps, can make the bump and pain worse.


Sever’s disease (calcaneal apophysate): Sever’s disease is a frequent cause of heel pain in active children between 8 and 14. Kids who participate in activities that require a lot of running and jumping are more prone to this problem. The increased athletic activity irritates the growth plate in the back of the heel.


What causes pain beneath the heel?

Problems that cause pain underneath the heel include:

Bone bruise (contusion): Stepping on a hard, sharp object can bruise the fat padding underneath the heel. You might not see discoloration, but your heel will feel tender when you walk. A stress fracture, as well as Sever’s disease, may cause pain all along the back of the heel on the bottom, side and back of the heel.


Plantar fasciitis: Plantar fasciitis is by far the leading cause of heel pain. It occurs when the fascia, connective tissue that runs along the bottom (plantar surface) of the foot, tears or stretches. People who run and jump a lot are more likely to develop this painful condition. Treadmills and hard surfaces (such as concrete) for exercise or work are common irritants.


Heel spurs: Chronic plantar fasciitis can cause a bony growth (heel spur) to form on the heel bone. Heel spurs aren’t usually painful, although some people have pain.


What are the risk factors for heel pain?

Anything that puts a lot of pressure and strain on your foot can cause heel pain. The way you walk (foot mechanics) and your foot's shape (foot structure) are also factors.

You may be more likely to develop heel pain if you:

Are overweight (have obesity).

Have foot and ankle arthritis, flat feet or high foot arches.

Run or jump a lot in sports or for exercise.

Spend a lot of time standing, especially on concrete floors.

Wear improperly fitted shoes without arch support and/or cushion.


What are the symptoms of heel pain?

Heel pain symptoms vary depending on the cause. In addition to pain, you may experience:

Bony growth on the heel.

Discoloration (bruising or redness).

Stiffness.

Swelling.

Tenderness.

Pain after standing from a resting/sitting position


Treatment

If you’re experiencing any foot pain or discomfort, call your Chiropractor and make an appointment for an adjustment. Chiropractic manipulative therapy (CMT) involves the application of pressure to a specific joint or set of joints in the body (by a chiropractic physician) in order to improve the alignment and function of that joint or joints, or to reduce pain or discomfort in that region. Our chiropractors do great work with feet, and adjustments can be an essential part of the recovery process; without proper joint motion, you cannot expect that the foot and ankle will move optimally. Adjustments alone, however, are rarely enough. You need to address the soft tissues of the foot, including the muscles, ligaments, nerves, and fascia. This can be done through in-office treatment (myofascial-type treatments)





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