Heel pain is a very common foot complaint and may involve injury to the bone, fat pad, ligaments, tendons or muscles. Heel Pain
can also be referred by a pinched nerve in your lower back. It is
important to have your heel pain thoroughly assessed to ensure an accurate diagnosis and subsequent treatment. Anyone can suffer from heel pain, but certain groups seem to be at increased risk,
including middle aged men and women, active people eg running sports, people who are very overweight, children aged between 8 and 13 years, pregnant women, people who stand for long periods of
Heel pain can have many causes. If your heel hurts, see your primary care doctor or orthopaedic foot and ankle specialist right away to determine why and get treatment. Tell him or her exactly where
you have pain and how long you've had it. Your doctor will examine your heel, looking and feeling for signs of tenderness and swelling. You may be asked to walk, stand on one foot or do other
physical tests that help your doctor pinpoint the cause of your sore heel. Conditions that cause heel pain generally fall into two main categories: pain beneath the heel and pain behind the
Both heel pain and heel spurs are frequently associated with an inflammation of the long band of tissue that connects the heel and the ball of the foot. The inflammation of this arch area is called
plantar fasciitis. The inflammation maybe aggravated by shoes that lack appropriate support and by the chronic irritation that sometimes accompanies an athletic lifestyle. Achilles Tendinopathy, Pain
and inflammation of the tendon at the back of the heel that connects the calf muscle to the foot. Sever?s, Often found in children between the ages of 8 - 13 years and is an inflammation of the
calcaneal epiphyseal plate (growth plate) in the back of the heel. Bursitis, An inflamed bursa is a small irritated sack of fluid at the back of the heel. Other types of heel pain include soft tissue
growths, Haglunds deformity (bone enlargement at the back of the heel), bruises or stress fractures and possible nerve entrapment.
After you have described your foot symptoms, your doctor will want to know more details about your pain, your medical history and lifestyle, including. Whether your pain is worse at specific times of
the day or after specific activities. Any recent injury to the area. Your medical and orthopedic history, especially any history of diabetes, arthritis or injury to your foot or leg. Your age and
occupation. Your recreational activities, including sports and exercise programs. The type of shoes you usually wear, how well they fit, and how frequently you buy a new pair. Your doctor will
examine you, including. An evaluation of your gait. While you are barefoot, your doctor will ask you to stand still and to walk in order to evaluate how your foot moves as you walk. An examination of
your feet. Your doctor may compare your feet for any differences between them. Then your doctor may examine your painful foot for signs of tenderness, swelling, discoloration, muscle weakness and
decreased range of motion. A neurological examination. The nerves and muscles may be evaluated by checking strength, sensation and reflexes. In addition to examining you, your health care
professional may want to examine your shoes. Signs of excessive wear in certain parts of a shoe can provide valuable clues to problems in the way you walk and poor bone alignment. Depending on the
results of your physical examination, you may need foot X-rays or other diagnostic tests.
Non Surgical Treatment
Early treatment might involve exercise and shoe recommendations, taping or strapping and anti-inflammatory medication (such as aspirin). Taping or strapping supports the foot, placing stressed
muscles in a restful state and preventing stretching of the plantar fascia. Other physical therapies may also be used, including ice packs and ultra-sounds. These treatments will effectively treat
the majority of heel and arch pain without the need for surgery.
When a diagnosis of plantar fasciitis is made early, most patients respond to conservative treatment and don?t require surgical intervention. Often, when there is a secondary diagnosis contributing
to your pain, such as an entrapped nerve, and you are non-responsive to conservative care, surgery may be considered. Dr. Talarico will discuss all options and which approach would be the most
beneficial for your condition.
Wear properly fitting shoes. Place insoles or inserts in your shoes to help control abnormal foot motion. Maintain a healthy weight. Exercise and do foot stretches as they have been shown to decrease
the incidence of heel pain.