The function of the heel in walking is to absorb the shock of your foot striking the ground as it is put down and to start springing you forward on the next step. It contains a strong bone (the
calcaneum). Under the bone are a large number of small pockets of fat in strong elastic linings, which absorb much of the shock (fat pads). The heel is attached to the front of the foot by a number
of strong ligaments which run between the front part of the calcaneum and various other parts of the foot. The strongest ligament is the plantar fascia, which attaches the heel to the toes and helps
to balance the various parts of the foot as you walk. It therefore takes a lot of stress as you walk. In some people the plantar fascia becomes painful and inflamed. This usually happens where it is
attached to the heel bone, although sometimes it happens in the mid-part of the foot. This condition is called plantar fasciitis and causes Heel Pain
Rheumatoid arthritis and other forms of arthritis, including gout, which usually manifests itself in the big toe joint, can cause heel discomfort in some cases. Heel pain may also be the result of an
inflamed bursa (bursitis), a small, irritated sack of fluid behind the heel. A neuroma (a nerve growth) involving the so-called Baxter's Nerve, (a nerve that courses under the heel bone), may also
cause heel pain that mimics the pain of a heel spur. Tarsal Tunnel Syndrome, a pinched nerve beneath the inside ankle bone, too, can cause pain in the heel. Haglund's deformity ("pump bump") is a
bone enlargement at the back of the heel bone, in the area where the Achilles tendon attaches to the bone. This sometimes painful deformity generally is the result of bursitis caused by pressure
against the shoe, and can be aggravated by the height or stitching of a heel counter of a particular shoe. Pain at the back of the heel is associated with inflammation of the Achilles tendon as it
runs behind the ankle and inserts on the back surface of the heel bone. The inflammation is called Achilles tendinitis. It is common among people who run and walk a lot and have tight tendons. The
condition occurs when the tendon is strained over time, causing the fibbers to tear or stretch along its length, or at its insertion on to the heel bone. This leads to inflammation, pain, and the
possible growth of a bone spur on the back of the heel bone. The inflammation is aggravated by the chronic irritation that sometimes accompanies an active lifestyle and certain activities that strain
an already tight tendon. Bone bruises (Periostitis), are also common heel injuries. A bone bruise or contusion is an inflammation of the tissues that cover the heel bone. A bone bruise is a sharply
painful injury caused by the direct impact of a hard object or surface on the foot. Stress fractures of the heel bone also can occur, but these are less frequent. On very rare occasions, there can be
problems within the bone structure itself that cause heel pain. Paget's disease, cysts, bone tumours, and other conditions can occur in the heel causing pain, so it is important to be examined
The symptoms of plantar fasciitis are pain on the bottom of the heel, pain in the arch of the foot, pain that is usually worse upon arising, pain that increases over a period of months. People with
plantar fasciitis often describe the pain as worse when they get up in the morning or after they?ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because
walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.
A biomechanical exam by your podiatrist will help reveal these abnormalities and in turn resolve the cause of plantar fasciitis. By addressing this cause, the patient can be offered a podiatric
long-term solution to his problem.
Non Surgical Treatment
The following steps may help relieve your heel pain. Use crutches to take weight off your feet. 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. Use a heel cup, felt pads in the heel area, or shoe insert. Wear
night splints. Your doctor may recommend other treatments, depending on the cause of your heel pain.
Only a relatively few cases of heel pain require surgery. If required, surgery is usually for the removal of a spur, but also may involve release of the plantar fascia, removal of a bursa, or a
removal of a neuroma or other soft-tissue growth.
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.