Heel pain is a problem we see in our clinic every day. There are different causes for heel pain with treatments effective at treating each problem.

My heel hurts on the bottom!

The most common cause of plantar heel pain is a condition called plantar fasciitis. The plantar fascia is a taut ligament that runs on the bottom of the foot from the heel to the ball of the foot. The function of the ligament is to support the arch of the foot. Depending on your foot structure and level of activity, too much stress can be put on this ligament causing inflammation and microscopic tears. Common initial treatments for this type of heel pain include increasing the range of motion of the ankle with stretching exercises, anti-inflammatory medication taken orally or injected directly into the heel, physical therapy, and/or providing appropriate support to the foot with foot orthoses and supportive shoe gear.

A second common cause of heel pain is a stress fracture. If you recently greatly increased your level of activity such as starting a new running routine, you are more likely to develop a stress fracture. Stress fractures are treated by immobilization using a walking boot or cast to allow the bone to heal.

I have been told I have “heel spurs.” What does that mean?

If you have limited ankle range of motion the plantar fascia applies a pulling force on the bottom of the heel causing a “spur” to grow on the heel. The “heel spur” is not usually the source of pain but it does mean that the plantar fascia is under increased stress which can result in plantar fasciitis and heel pain.

My pain is on the back of the heel!

The most common cause of posterior heel pain is due to irritation or damage to the Achilles tendon. This tendon attaches to the back of the heel and if the calf muscles are tight too much a pulling force is applied to the heel causing pain. You may also have a prominence of bone on the top of your heel called a Haglund’s deformity. This can rub on the tendon itself causing potential damage or irritation. Common initial treatments for this type of heel pain include increasing the range of motion of the ankle, placing a temporary heel lift into the heel to offload the tendon or fully resting the tendon in a walking boot. Physical therapy is also effective at treating this source of pain. Sometimes surgery is performed to remove the prominence on the heel bone and repair the tendon to relieve pain and prevent the problem from returning.

My child has heel pain!

The most common cause of heel pain in children is Sever’s disease, also called calcaneal apophysitis. This is pain at the growth plate where the bone is still growing. This pain will go away with time similar to a “growing pain” and can be relieved with heel offloading in the shoe and exercises to increase range of motion of the ankle.

There is no reason to live with heel pain. Contact our office today at (812) 372-6274 to set up an appointment for a consultation with one of our foot and ankle specialists.