Common Causes Of Heel Pain

Plantar fasciitis is the most common cause of heel pain. This is due to the inflammation of the plantar fascia, a strong fibrous tissue found underneath the foot and connects to the calcaneus or heel bone to the metatarsals of the feet. 

If you experience heel pain when you take your first steps in the morning of after standing for long periods of time, then probably plantar fasciitis is the most probable cause. Plantar fasciitis also causes arch pain.

Heel spurs which are abnormal growths or protrusions of bone on the bottom of the heel bone, may cause foot pain when walking or standing. Heel spurs are commonly seen in people who suffer from plantar fasciitis, but heel spurs do not cause plantar fasciitis. If you have high arches or flat feet, then most probably you are suffering from heel spurs.

A fracture of the heel bone is most often caused by high impacts to the heel, typically a fall from high ground. Pain, swelling, bruising, limping and difficulty walking are all signs of a fractured foot.

A stone bruise is due to bruising of the fat pad of the heel. This occurs after stepping on a pebble or a small stone or any hard object. The heel may not change color  after the bruise. Pain reduces and disappears with rest.

Heel Pain Treatments

For Plantar fasciitis: RICE method

1.       Rest

2.       Ice

3.       Compress

4.       Elevate

For heel spurs:

1.       Custom made inserts

2.       Cut out heel pads

3.       Pain relievers

4.       Rest

5.       Surgery

For heel fractures

1.       Rest

2.       Padding or casting of the heel

3.       Pain relievers

4.       Surgery

Understanding the Development of A Heel Spur

What is a heel spur?

A heel spur is a bony formation located at the calcaneous bone or heel bone that is evident through x-ray. Also called calcaneal spur, this condition is commonly associated with plantar fasciitis when the spur is located at the inferior part or at the bottom of the calcaneous bone.

Though these conditions are related, they are two separate disease entities. Plantar fasciitis refers to the irritation or inflammation of the plantar fascia, and this is sometimes accompanied by a spur. But not all patients with plantar fasciitis develop a heel spur and not all patients with heel spurs have plantar fasciitis.

Heel spurs are seen on patients who have chronic heel pain due to the inflammation of the plantar fascia. This is often seen on middle aged men and women or among active athletic individuals involved in sports like runners, basketball players and volleyball players.

Patient don't actually complain of heel spur pain but pain from plantar fasciitis. Most often, a heel spur can only be found or diagnosed through radiological findings where the pointy bony prominence is located at the attachment of the plantar fascia.

How do heel spurs form? About 70% of patients with plantar fasciitis will develop heel spurs. The plantar fascia, which is located at the bottom of the foot, is a strong fibrous tissue that attaches to the heel bone to the balls of the foot. It is responsible for the arch of the foot and plays a major role in the biomechanics of the foot. This fascia is also under enormous stress when running, walking or bearing weight.

However, this important structure is very prone to injury and degenerative changes. The natural wear and tear of this tendon can cause irritations and inflammation causing chronic heel pain. For some reason, the new bone growth is formed at the attachment of the plantar fascia to the heel bone probably because of the constant stressful pulling action.

Treating pain associated with heel spurs and plantar fasciitis can be done conservatively. Most often, the R.I.C.E. method which stands for rest, ice, compress, and elevate can effectively relive pain. Other treatments are foot inserts, pain medications and steroid injections.

A new treatment called ESWT uses multiple shock waves to naturally stimulate healing in the injured fascia. This is a holistic approach since it encourages the bodies own healing properties.

For more information about heel spurs and plantar fasciitis, please visit the Family Foot and Leg Center in Naples or Contact Dr. Kevin Lam at (239) 430-3668.