Heel pain comes in many varieties, though there are some common contributing factors. The three most significant contributors are faulty foot mechanics (the way your foot works may be a product of your parents or grandparents), how many steps you take each day, and your body mass (BMI). A high BMI or an increase in total steps per day put more stress on your feet that are beyond what your biomechanics can handle.
At our office, we’ll always take the time to answer your questions, listen to your concerns, and perform a thorough evaluation (and, if necessary, an X-ray or ultrasound) to make sure we know exactly what is causing your problem and what to do about it. For more information about each type of heel pain, click on the links below:
- Plantar fasciitis. This is the most common type of heel pain. It’s caused by damage to a very strong ligament (plantar fascia) that begins under the heel, passes under your arch, and extends into the toes. The classic symptom is pain directly under the heel that spikes in the early morning, right after you get out of bed or after rest. Chronic plantar fasciitis can eventually create heel spurs, small bony deposits that build up where the plantar fascia meets the heel bone.
- Achilles tendinitis. Often used as a catch-all term for any inflammation, injury, or degeneration of the tendon, this condition causes pain just above the back of the heel, where the tendon inserts into the heel bone called the calcaneus. Pain can develop where the tendon attaches to the calcaneus (insertional Achilles tendonitis) or higher up in the tendon itself.
- Haglund’s deformity. Also known by the moniker “pump bump,” it’s a bony and soft tissue enlargement at the back of the heel that is common among those who wear pumps (or other high-heeled shoes).
- Sever’s disease (juvenile Plantar Fasciitis). This form of heel pain features an irritated growth plate at the back of the calcaneus. It is most often found in active children during a rapid growth spurt. The pain is most noticeable around the outside portion of the heel; squeezing the sides of the heel produces the greatest discomfort. The cause of heel this heel pain is the same for a child or an adult.
- Bursitis. Sometimes confused with Achilles tendonitis, bursitis is swelling and inflammation in a small, fluid-filled sac called the retrocalcaneal bursa, which normally provides cushioning and lubrication to help the Achilles, calf muscles, and bones glide together smoothly.
- Tarsal tunnel syndrome. Similar to carpal tunnel syndrome in the wrist, this involves the compression of a large nerve running through a tight space in the inside of the ankle. The compression of this nerve can lead to pain, tingling, numbness, or an electrical type sensation that goes through the bottom of the foot. The longer the symptoms are present, the more damage is occurring to the nerve.
- Stress fractures. Repetitive, heavy impacts (as might be the case with runners, basketball players, or laborers) can cause tiny, even microscopic, cracks to form on the bones of the feet, including the calcaneus. The calcaneous is made to take an abundance of impact and it is unusual to see a stress fracture at this location; but it is possible with extreme activity or a history of an injury like landing from a tall height.
Halting the Pain and Getting You Back on Track
Once Dr. Leibovitz makes a positive diagnosis and has a chance to speak with you about your goals and needs, he will develop a course of treatment that’s right for your situation.
Conservative therapies are often the first choice, especially in the earliest stages of your condition. We want you to remain as active as possible during recovery. Common pain-relieving strategies may include physical therapy, over-the-counter medications, cortisone shots, ice, or massage. See my blog on other treatments for heel pain, too.
Heel pain is often related to underlying foot deformities or other attributes (like tight calves). In such cases, custom orthotics can relieve the pain by accommodating or correcting irregularities in foot structure or walking gait. Stretching and physical therapy may help, too, along with above-the-knee night splints to stretch the Achilles and plantar fascia while you sleep.
For more serious conditions, or instances where conservative options have not proven sufficient, we may look at surgery as an option. Rest assured that Dr Leibovitz is highly trained and will help select the best possible procedure for your situation. We’ll give you instructions that will help you achieve the fastest, most thorough recovery possible.
To schedule an appointment with Jeffrie C. Leibovitz, D.P.M., please call today at 317-545-0505. You can also request an appointment using our online contact form—just fill in the necessary information and our friendly staff will contact you shortly thereafter.