What are the most common causes of heel pain?
Plantar fasciitis is the most common cause of heel pain. Plantar fasciitis is tearing and inflammation at a long ligament in the bottom of the foot. The tearing and inflammation result in pain at the arch and the heel. Ninety percent of people who experience heel pain have plantar fasciitis. Other causes of heel pain include:
Achilles tendonitis: This type of heel pain occurs at the back of the heel instead of the bottom of the heel. Achilles tendonitis is an overuse injury and is treated in a similar way to plantar fasciitis. Stretching of the calf muscle, icing, contrast soaks, heel lifts and rest will decrease the stress and inflammation and accelerate the healing process.
Stress fracture of the heel: This is an incomplete break in the heel bone and can result from overuse. The pain is typically sharp with walking and activity and is improved with rest. There is usually some swelling and sometimes bruising around the heel area. Stress fractures can take 2-4 weeks to show up on X-ray and will take 6-8 weeks to heal.
Heel spur fracture: The spur on the bottom of the heel can break off from the heel bone. This typically results from an injury, or could occur from jumping and landing wrong on the heel. This is uncommon and results in instant pain, swelling and bruising. An X-ray will show the break and it will take 6-8 weeks to heal.
Heel neuroma: This is an inflamed nerve in the heel which typically develops from excess rub, injury or other aggravating factor. The pain is typically sharp, sometimes electrical or burning on the inside of the heel. The treatment involves removing the aggravating factor and decreasing the inflammation with ice, contrast soaks, anti-inflammatory medications, steroid injections and sometimes surgery.
Bone tumor/cyst: Bone tumors or bone cysts rarely occur in the heel bone and when they do, they are typically benign. Most benign tumors are not treated because they do not cause any pain. If the benign tumor or cyst does cause pain, they can be surgically removed.
Arthritis: There are many types of arthritis that are associated with heel pain. Rheumatoid arthritis, Chron's disease, psoriatic arthritis, anklyosing spondylitis and Reiter's syndrome are systemic arthritic diseases that can cause inflammation at the plantar fascia as it attaches to the heel bone. Crohn's disease can cause similar symptoms. The treatment regimen is essentially the same as treating plantar fasciitis.
More information and images on plantar fasciitis.
More information on the causes of heel pain.
last updated 6/21/10
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