As the largest bone in your foot, your heel bone and its supporting structures are routinely subjected to a high degree of stress. When that stress begins to affect the integrity of any part of its structure, your heel will let you know — usually in the form of persistent heel pain.
Bothersome heel pain is one of the most frequent patient complaints we hear at California Foot and Ankle Clinic in Riverside, California. Read on as expert podiatrists, Sahand Golshan, DPM, and Ivan Aguilera, DPM, explore three of the most common causes of heel pain, including how they’re treated.
1. Plantar fasciitis
Heel pain is frequently associated with plantar fasciitis, an overuse injury that affects the sole of your foot. It occurs when your plantar fascia, the thick band of tissue that provides flexible, shock-absorbing support through the arch of your foot, develops microscopic tears that lead to collagen degeneration and acute inflammation.
Plantar fasciitis can cause arch pain, but in most cases, it triggers acute heel pain because that’s where the plantar fascia is rooted. Early on, pain is typically mild and resolves with activity.
Many people experience their worst plantar fasciitis symptoms — moderate to severe heel pain — during their first few steps of the day, or after a long period of sitting. Left untreated, heel pain may start to occur during exercise or when you’re on your feet for long stretches.
You may be more susceptible to developing plantar fasciitis-related heel pain if you:
- Are flat-footed or have a high arch
- Often stand for long periods of time
- Wear shoes without arch support
- Have diabetes or are very overweight
- Become very active too quickly
Poor foot biomechanics that lead to inefficient walking patterns can also place added stress on the soles of your feet and cause plantar fasciitis.
2. Achilles tendinitis
Pain at the back of your heel is commonly a result of Achilles tendinitis, an overuse injury that affects the thick band of tissue that connects your calf muscle to your heel bone. Because this tendon provides push-off power when you’re walking or running, it’s routinely under pressure. Too much stress, however, can trigger inflammation and tissue degeneration.
Pain at the back of your heel that radiates up your calf is a tell-tale sign of Achilles tendinitis. For many people, it begins as mild heel pain that extends up the back of your leg following a walk, run, or some other intense activity.
Achilles tendinitis can also cause heel and ankle stiffness that’s most pronounced after rest, and improves with moderate activity. Intense or prolonged activity tends to trigger severe heel and calf pain.
You may be more likely to develop Achilles tendinitis-related heel pain if you:
- Have tight calves and/or flat feet
- Struggle with poor foot biomechanics
- Wear unsupportive shoes or high heels
- Play sports that involve jumping
- Run on hilly terrain or soft surfaces
Achilles tendinitis is a common overuse injury among high-intensity athletes and weekend warriors alike; it’s also a common degenerative injury among middle-aged and older adults.
3. Sever’s disease
Sever’s disease is a frequent cause of heel pain in older kids and adolescents. Also known as calcaneal apophysitis, it occurs when excessive stress on your child’s actively growing heel bone causes growth plate inflammation in their heel. Sever’s disease is one of the most common pediatric developmental conditions.
Heel pain, along with swelling, redness, and tenderness at the back of your child’s heel, are the main symptoms of Sever’s disease. Many kids experience discomfort or stiffness when walking and find it difficult to run; in most cases, heel pain is worsened by activity and eased with rest.
Your child may be more likely to develop Sever’s disease-related heel pain if they:
- Are very physically active
- Have flat feet or high arches
- Wear tight, poorly fitting shoes
- Are very overweight or obese
- Overpronate when walking
Sever’s disease affects girls between the ages of 8-13 and boys between the ages of 10-15 most often.
Heel pain treatment solutions
When it’s diagnosed and treated soon after onset, heel pain usually responds very well to conservative treatment measures, including:
- Rest or reduced activity
- Ice and elevation
- Targeted stretching exercises
- Anti-inflammatory pain relievers
- Taping or splinting
Our team may also make footwear recommendations or suggest custom-fitted orthotics. For severe inflammation, corticosteroid injections can help. Once your inflammation is under control, physical therapy exercises can help restore foot flexibility and stability.
It’s important to treat heel pain before it becomes a chronic condition that affects the way you walk, makes you less active, or triggers the development of painful bone spurs on your heel.
If you’re experiencing unexplained heel pain, schedule a consultation with one of the skilled podiatrists at California Foot and Ankle Clinic. Call our office at 951-405-8500 today.