Causes of Heel Pain

Every mile you walk places a tremendous amount of stress on your feet.  The good news is your feet can handle a heavy load, but too much stress may push them past their limit.  The shoes you wear or surfaces you train or walk on can increase the stress level.  Heel pain is commonly one of the first signs that too much stress is being placed on your feet.  A sore heel with usually get better on its own with adequate rest.  The problem is many people try to ignore the early signs of heel pain and continue the activities that caused it.


Heel pain can have many causes.  It is important to see the podiatrists at Coastal Podiatry Associates right away to determine why your foot is painful and determine the proper treatment.  The doctors will begin by asking where exactly the pain is located and how long you have had it.  Next, they will examine your foot, looking and feeling for signs of tenderness, swelling, and bruising.  The doctors may ask you to walk, stand on one foot, or other physical tests that help determine the pain’s cause.  Conditions that cause heel pain generally fall into two main categories: pain beneath the heel and pain behind the heel.


If the pain is greatest under you heel, you may have a condition causing inflammation in that area.  A stone bruise occurs after stepping on a hard object such as a rock or stone.  The object can bruise the fat pad on the underside of the heel and pain gradually reduces with rest.  Plantar fasciitis typically occurs after too much running, jumping, or stretching of the tissue band that connects the heel bone and the base of the toes.  The pain in centered under the heel and is most intense with taking your first steps after resting.  A heel spur is another cause of pain and can form from long standing plantar fasciitis.  An X-ray may be used to visualize the increased boney projection from the heel.


Pain behind the heel is generally due to the Achilles tendon.  This condition is called retrocalcaneal bursitis and is an inflammation of the insertion of the Achilles tendon into the heel bone.  People often develop this by running too much or wearing shoes that rub or cut into the back of the heel.  This irritation can cause a slow increase in skin thickness, redness, or swelling.  A bump that is tender and warm to touch may also develop.  Pain is most severe with first activity after resting.  It is not uncommon for the pain to be so severe that normal shoes cannot be worn.  After taking X-rays, a podiatrist will common prescribe stretching exercises, anti-inflammatory medications, and icing.