Pain in the heel is
one of the most
common complaints
that a foot
specialist hears.
The cause of heel
pain is one of the
most controversial
subjects in the
specialty. With
treatment, however,
most patients can be
relieved of their
symptoms.
The Cause
The most common
cause of heel pain
is the pull on the
heel exerted by the
muscles and
ligaments that
support the arch of
the foot, an overuse
condition similar to
bursitis of the
shoulder or tennis
elbow.
Other causes of heel
pain include: nerve
entrapment, stress
fracture of the heel
bone, inflammatory
diseases (such as
rheumatism or gout),
or a bruise of the
fat pad under the
heel.
The Condition
The pain typically
is worse in the
morning and with
walking, but tends
to lessen throughout
the day.
Individuals with
flat feet and tight
heel cords are
frequently affected,
as are those who are
overweight or overdo
in athletics.
A heel spur is seen
on X-ray in only
about half the cases
of heel pain, It
forms at the
attachment of
muscles and
ligaments to the
heel. Heel spurs
are not the cause of
pain, however, many
heel spurs are not
painful at all.
The Treatment
Heel pain, even without
treatment,
will usually
subside, but may
take a long time.
The treatment is
done in stages,
according to the
duration of the
problem and the
degree of the pain.
-
Stage I:
Anti-inflammatory
medications, shoe
modifications,
shoe inserts,
temporarily
limited activities
and heel cord
stretching will
usually relieve
the condition when
it begins.
-
Stage III:
For the difficult,
chronic problem, a
cast can be
tried. Either a
removable type
such as a slipper
cast, a cast
brace, or a
standard walking
cast. A night
splint can also
help.
