Heel Pain

Heel pain occurs when the bones, muscles, or other soft tissues of the heel are inflamed or damaged.

The main symptoms are discomfort and pain in the heel. These symptoms become acute when the person goes about his or her daily routine, especially if exercise is involved. The person may also have swelling or bruising of the soft tissues of the heel.

Some of the factors that can cause heel pain include:

• plantar fasciitis, an inflammation of the sole of the foot
• a bruise from hitting the heel against a hard object
• Achilles tendinitis, an inflammation of the Achilles tendon that runs down the back of the heel
• gout, which is a disease that causes painful joints
• inflammatory bursitis, which is a condition caused by the tendon rubbing on the back of a shoe
• medial calcaneal neuroma, a condition in which the nerve on the inside and bottom of the heel becomes irritated and enlarged
• a misshapen heel bone
• rheumatoid arthritis, a severe form of arthritis that causes pain, swelling, inflammation, and, sometimes, destruction of the joints
• Reiter's syndrome, a type of arthritis that causes pain, swelling and redness in the joints

Very rarely, cancer involving the bone can cause heel pain.

To prevent heel pain, one should avoid activities that can damage the heel. Also, one should choose footwear that is right for the activity being performed. For instance, it is helpful to wear a thick-soled boot when digging with a shovel and sturdy, supportive running shoes when jogging.

Sometimes a person who knows what activity is causing his or her pain and where it is coming from is able to diagnose the problem him- or herself. Some conditions are less obvious and will require the help of a healthcare professional, who can often make the diagnosis with a simple physical exam. Other times, X-rays or special studies, such as bone scans, computerized tomography (CT) scans, or magnetic resonance imaging (MRI) are needed. If the problem involves inflammation, a complete evaluation for the causes of arthritis may be necessary.

Most heel pain resolves quickly with treatment. But if the heel pain is an early sign of arthritis, it could eventually affect other parts of the body.

Heel pain is not contagious and poses no risk to others.

Treatment begins by protecting the affected area from further irritation. Other measures used to treat heel pain include the following:

• anti-inflammatory medications, such as ibuprofen (i.e., Advil, Motrin) or aspirin
• ice packs
• physical therapy
• proper-fitting footwear

Anti-inflammatory medications can cause stomach upset and allergic reactions.

Heel pain from an acute injury usually clears up without further diffidculty. Heel pain chronic conditions such as gout or arthritis may require lifelong treatment.

Any new or worsening symptoms should be reported to the healthcare professional.