Heel pain
A podiatrist will determine the cause of the heel pain. Most heel pain is caused by mechanical injury. This could be small repetitive injuries that can occur faster than the body can heal. It can also be due to injuries/lower back problems and inflammatory joint conditions.
Planter Fasciitis
Damage to tissue (fascia) that connects the heel bone to the base of the toes. It tends to be painful, particularly on rising in the morning. Treatments include special stretching exercises and foot assessment to check alignment problems and other possible causes.
Tarsal Tunnel Syndrome
Can present as a burning or tingling sensation underneath the heel and in the arch of the foot. Caused by compression of the tibial nerve as it passes the inside of the ankle. Special shoe inserts can reduce the pressure and may be appropriate for certain foot types. Local injections to reduce inflammation may be necessary.
Calcaneal Bursitis
Inflammation of a bursa (a fluid filled fibrous sac) under the heel bone. The pain typically is more to the centre of the heel and can worsen during the day. Medication and ultrasound can give relief but for long-term relief a shoe insert may be necessary.
Chronic Inflammation
Caused by a heavy heel strike or sometimes a reduction in the thickness of the heel pad that can give rise to a dull ache in the heel when standing and walking that increases during the day. A soft heel cushion can help.
Stress Fracture
This can occur following injury. If a fracture is suspected an X-ray would be required to confirm diagnosis and determine the extent of the injury and therefore treatment protocol.
Severs disease
This condition affects young children, normally between the ages of 8 and 12. It occurs when part of the heel bone suffers a temporary loss of blood supply and as a result the bone dies only to reform when the blood supply is later restored. It is a condition known as osteochondrosis that can occur in growing bones and one that fortunately is self-limiting but can be painful at the time.
Achilles Tendonosis
This can occur when the Achilles tendon is placed under more tension than it is able to cope with and as a result small tears develop. These then become a source of further injury and gradually a swelling may develop within the tendon. Treatment will involve special exercises to strengthen the tendon and temporarily increasing the height of the heel with an insole.
Other forms of pain associated with the Achilles tendon include paratendonitis (involving tissues surrounding the tendon) and Achilles enthesis (inflammation of the insertion of the tendon to the heel). Once again differentiating between these conditions is important as each requires slightly different treatments.