Pain - heel

Heel pain is most often the result of overuse. Rarely, it may be caused by an injury.

Your heel may become tender or swollen from:

• Shoes with poor support or shock absorption
• Running on hard surfaces like concrete
• Running too often
• Tightness in your calf muscle or the Achilles tendon
• Sudden inward or outward turning of your heel
• Landing hard or awkwardly on the heel

Conditions related to heel pain include:

• Achilles tendinitis, inflammation of the large tendon that connects your calf muscle to your heel
• Bursitis, inflammation of the back of the heel
• Bone spurs in the heel
• Plantar fasciitis, swelling of the thick band of tissue on the bottom of your foot
• Calcaneus fracture, fracture of the heel bone that is related to landing very hard on your heel from a fall

The following steps may help relieve your heel pain:

• Rest as much as possible for at least a week.
• Apply ice to the painful area. Do this at least twice a day for 10 to 15 minutes, more often in the first couple of days.
• Take acetaminophen or ibuprofen for pain.
• Wear proper-fitting shoes.
• A heel cup, felt pads in the heel area, or shoe insert.
• Night splints.

Other treatments depend on the cause of your heel pain.

Call your doctor if your heel pain does not get better after 2 - 3 weeks of home treatments. Also call if:

• Your pain is getting worse despite home treatment
• Your pain is sudden and severe
• You have redness or swelling of your heel
• You cannot put weight on your foot

Your doctor will perform a physical exam and ask questions about your medical history and symptoms, such as:

• Have you had this type of heel pain before?
• When did your pain begin?
• Do you have pain upon your first steps in the morning or after your first steps after rest?
• Is the pain dull and aching or sharp and stabbing?
• Is it worse after exercise?
• Is it worse when standing?
• Did you fall or twist your ankle recently?
• Are you a runner? If so, how far and how often do you run?
• Do you walk or stand for long periods of time?
• What kind of shoes do you wear?
• Do you have any other symptoms?

Your doctor may order a foot x-ray. Treatment depends on the cause of your foot pain. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot. Your doctor may recommend a night splint to help stretch your foot.

Maintaining flexible and strong muscles in your calves, ankles, and feet can help prevent some types of heel pain. Always stretch and warm-up before exercising.

Wear comfortable, properly fitting shoes with good arch support and cushioning. Make sure there is enough room for your toes.

Wapner KL, Parekh SG. Heel pain. In: DeLee JC, Drez D Jr,Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:section F.

Abu-Laban RV, Ho K. Ankle and foot. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 55.