Soreness and inflammation in the heel is most commonly associated with simple overuse, but it can also indicate a more serious underlying condition. For example, bone spurs developing on the heel bones rub against the muscles, resulting in sharp and acute pains. Plantar fasciitis, which can be dull or sharp, is a persistent heel pain caused by irritation of the fascia tissue connecting the heel to the toes.
Most heel irritations are caused by an initial injury, persistent overuse, or too much strain on the area due to improper gait and posture.
The pain in the heel area is often accompanied by other symptoms, depending on the underlying cause.
Serious symptoms which deserve a doctor’s attention include:
There are many potential causes of heel pain, with the simplest being a bruise on the underside of the heel, usually sustained by stepping on a stone or other hard object.
Plantar fasciitis is another common cause of heel pain on the underside of the foot. This occurs when the tissues which connect the heel to the base of the toes – the fascia – become inflamed, often due to excessive running or jumping.
Sometimes heel spurs are the cause of heel pain. Usually, these occur after plantar fasciitis has continued for a long time, and deposits of calcium build up in the area. Like plantar fasciitis, heel spurs cause pain on the underside of the foot.
If heel pain occurs behind the heel rather than under the foot, there could be an issue with the Achilles tendon. A condition known as retrocalcaneal bursitis can cause inflammation and pain in the area where the Achilles tendon connects to the heel.
Often, this is caused by excessive running or wearing shoes which dig into the back of the heel over long periods of time. In rare instances, particularly if the pain is accompanied by a bump, pain in this area can be caused by a bone spur.
Treatment is usually conservative at first. Patients who experience heel pain for the first time usually use rest and ice to resolve the pain within a few days.
If there are more serious symptoms present or the home treatment doesn’t work, the doctor may need to perform surgery to adjust the plantar fasciitis or trim down the bone spurs. These surgeries are only necessary for severe and chronic heel pain problems, not just irritation that comes and goes. Using a supportive heel insert is the best way to reduce or prevent pain and other symptoms caused by overuse and injury.
The only way to prevent heel pain is to prevent injury to the heel and foot. Often, conditions which cause heel pain are caused by repetitive movements, incorrect form or unsupportive footwear. For example, if you go running frequently, you should replace your running shoes regularly and only wear shoes that give your foot adequate support.
Very flat or very high shoes can contribute to heel pain and injury. Although wearing high heels every now and again isn’t usually a problem, doing it daily could be. Flat shoes aren’t good for feet either; a low shoe which can support the natural shape of the heel and arch of the foot is usually better than a completely flat shoe.
You should also avoid walking barefoot on hard ground, particularly if you only do this very rarely. Those who do it regularly are able to build additional strength in the feet, but those who rarely walk barefoot on hard surfaces are likely to notice the sudden, extra pressure on their heels.