Why Does Your Heel Hurt?

Pain in heel is usually not caused by injuring your heel once, but rather injuring it repetitively.

Heel pain is caused due to the following:

• Plantar fasciitis: It is characterized by inflammation of plantar fascia, which is a strong ligament between the heel bone and the foot tip. The fibers of the ligament get inflamed when the plantar fascia is stretched too much. This usually happens where it is attached to heel bone. Pain occurs beneath the foot particularly after resting for long period.

• Heel bursitis: It is characterized by inflammation of a bursa situation on back of heel. It may be caused due to landing on heels or pressure on heels from footwear. Pain is felt at back of heel or deep inside heel. Swelling of Achilles tendon may occur in some cases. The pain worsens at the end of the day.

• Heel bumps: It is commonly seen in teenagers and often results due to a flat foot. When the heel bone is still immature, it rubs excessively and results in formation of excessive bone.

• Tarsal tunnel syndrome: It is a form of compression neuropathy in which a large nerve at the back of foot gets entrapped or pinched. This is one of the reasons you may say my heels hurt.

• Chronic inflammation of heel pad: This may occur due to either heavy footsteps or heel pad getting too thin.

• Stress fracture: A fracture caused as a result of repetitive stress such as due to sports, heavy exercise or strenuous manual work. Athletes particularly runners are prone to develop stress fracture in foot bones. Osteoporosis may also cause stress fracture in foot.

• Severs disease: It is among the most common cause of pain in heel in teenage/child athletes, which is caused as a result of repetitive micro trauma in growth plates of heel bone. Children in the age group 7-15 years are more commonly affected by this disease.

• Achilles tendonosis: It is also referred to as tendinosis, tendinopathy and tendonitis. It is a chronic disease in which the Achilles tendon is continuously degenerated. More stress is put on the Achilles tendon then it can handle so that microscopic tears form in the tendon, which are not able to repair and heal correctly. Eventually there is thickening and weakening of the tendon and it becomes painful.

Some other causes of heel pain and why you say my heels hurt are:

• Rupture of Achilles tendon: The tendon situated behind ankle joint gets torn.

• Bone bruise

• Gout: Gout is characterized by raised uric acid levels in blood resulting in accumulation of urate crystals in the joints. This results in attacks of gout which causes severe pain and inflammation.

• Bone cyst: A single cyst filled with fluid forms in the bone

• Morton’s neuroma: A nerve gets swollen in the top of the foot, most commonly between base of third and second toes.

• Osteomyelitis: It is characterized by inflammation of the bone due to infection, which may occur due to complication of surgery or injury. The infection may also travel into the bone from blood. There is pain, fever and muscle spasm.

• Peripheral neuropathy: It happens when nerve axons are damaged. The symptoms are numbness and pain in feet and hands. The most common cause is diabetes and other causes are infections, toxin exposure and traumatic injuries.

• You may also develop heel pain if you have wrong posture while walking or running.

• Rheumatoid arthritis: It is a chronic, autoimmune disorder that results in pain and inflammation in joints. It usually affects joints of hands and feet initially. The patients develop stiff joints and general feeling of tiredness and fatigue.

• If you wear high heels, sandals and pumps, then you may develop heel pain later in your life. This is one of the causes you may say my heels hurt.

Pain in heel develops gradually without any injury to the area affected. It is very often triggered when you wear flat footwear including flip-flop sandals. The plantar fascia gets stretched by wearing flat shoe and gets inflamed. In majority of the cases, pain develops beneath the foot at the front portion of heel.

Symptoms of pain are worse in morning when you get out of bed and after resting for some time during daytime. This is also referred to as post-static dyskinesia. The symptoms may improve after some activity. However, they worsen at the end of day.

When Should You Call Your Physician?

Visit your physician as early as possible if you develop any of the following:

• Severe pain associated with swelling in your heel

• Tingling or numbness in heel along with fever and pain

• Pain in heel and fever

• You are not able to walk in normal manner.

• You are unable to bend the foot downwards.

• You are unable to rise on your toes.

• You have persistent heel pain for greater than a week.

• Heel pain persists even if you are not walking or standing.

Treatment of Heel Pain

Try the following at home to relieve heel pain:

• Take lots of rest.

• Apply ice pack to heel for about 12-15 minutes two times each day.

• Take OTC pain killers.

• Wear shoes with proper fitting.

• Wear night splint-it is used to stretch your foot during sleep.

• Use shoe inserts or heel lifts to ease pain.

If your pain is not relieved by these home measures, visit a physician. They may perform physical exam and X-ray to find out the cause of pain. They may recommend physical therapy and anti-inflammatory medicines. You may be advised to support the foot either by taping it or by utilizing special devices. Surgery may be recommended very rarely as it needs long time to recover and may not relieve heel pain.

Prevention of Heel Pain

Some steps to avoid injuring your heel and preventing pain are:

• Wear right footwear during physical activity.

• Wear footwear that support your foot and fit properly.

• Before exercising always do stretching of your muscles.

• Eat a healthy and well-balanced diet.

• Maintain an optimum and healthy weight.

• Rest when you are tired.