In the human foot, the heel bone, also known as the calcaneus, stands out as the largest among the 26 bones. It plays a crucial role in forming the heel, along with a thick layer of connective tissue beneath it called the fat pad and a fluid-filled sac known as the retrocalcaneal bursa sac located near the back of the heel. These structures reduce friction and aid in the smooth movement of the Achilles tendon over the bone where it attaches.
Common Causes of Heel Pain
Heel pain can stem from various conditions or injuries, including:
Plantar fasciitis. This condition arises due to excessive stress on the calcaneus and its connective tissues from physical activity, obesity, or inappropriate footwear. Plantar fasciitis occurs when the plantar fascia tissue, connecting the heel bone to the ball of the foot, becomes overly stretched, leading to pain and inflammation, especially during the morning.
Heel spurs. If left untreated, plantar fasciitis can progress into a chronic condition, possibly resulting in the formation of heel spurs on the heel bone. Heel spurs are calcium deposits that form in response to repeated stress, which may or may not cause pain.
Acute injuries. Injuries directly impacting the heel bone, like fractures or contusions, can induce intense pain, swelling, and challenges in putting weight on the injured heel.
Gout. Gout is a form of arthritis characterized by the accumulation of uric acid crystals in the bloodstream, which can occasionally develop on the heel bone, causing pain, tenderness, swelling, and redness, often worsening at night.
Gait anomalies. Distinct walking abnormalities, such as excessive pronation where the ankle rolls inward excessively, can exert undue pressure on the heel bone's ligaments and tendons, leading to heel pain.
Haglund’s deformity. This bony enlargement at the back of the heel often referred to as "pump bump," is frequently linked to wearing high heels and may play a role in causing heel discomfort.
Achilles tendinitis. This situation arises when the Achilles tendon, which links the muscles of the calf to the heel bone, experiences unusual stretching or tearing, leading to pain and inflammation where it attaches to the heel bone.
Bursitis. Inflammation of the bursa sac, which acts as a cushion between the Achilles tendon and the heel bone, can lead to painful symptoms.
How a Podiatrist Diagnoses and Treats Heel Pain
Heel pain can be diagnosed by a podiatrist through a comprehensive examination and, if necessary, imaging tests. The treatment methods vary based on the severity and type of condition and often encompass conservative approaches such as
- Taping or strapping
- Extracorporeal shockwave therapy
- Changes in footwear
- Orthotics
- Physical therapy
- Steroid injections
- MLS laser therapy
Persistent heel pain, with or without signs like inflammation, redness, warmth, or swelling, warrants attention from a podiatrist. Ensure you seek proper diagnosis and treatment by scheduling an appointment promptly to address your condition effectively.
