Pain in the heel, the back of the foot, is a very common symptom in adults. It usually develops gradually and gets worse over time. Often the pain can become intense and manifest when weight is shifted onto the heel. In most cases, pain occurs in only one heel, although estimates indicate that in about one third of the population it occurs in both heels.
The pain is usually worse in the morning or when you start walking after a period of inactivity. Generally with movement it decreases but in some cases it gets worse after walking or standing for a long time. Some people end up limping or hitting an abnormal gait in an attempt to avoid putting weight on the sore heel.
Heel pain typically occurs due to inflammation of the plantar fascia. The plantar fascia is a strong and flexible muscular / fibrous fascia that extends from the bottom of the heel to the base of the toes, acting as a kind of shock absorber. Sudden or over time damage can produce small tears and cause thickening of the plantar fascia resulting in heel pain. Sometimes, surrounding tissue and heel bone can also become inflamed.
In most cases, heel pain occurs in the presence of plantar fasciosis, generally due to mechanical stress or in cases of plantar fasciitis characterized, instead, by inflammation of the plantar fascia.
There are several treatments available that can relieve heel pain and accelerate its disappearance:
- rest, avoid walking for long distances and for long periods
- stretching of the calf muscles and plantar fascia
- applications of ice on the heel and, if necessary and on the advice of the doctor, taking pain-relieving medicines, such as non-steroidal anti-inflammatory drugs (NSAIDs)
- use of shoes that fit well, able to support and support the foot. Running shoes are particularly useful
- use of support devices for the sole of the foot such as insoles (rigid supports that are placed inside the shoe), braces or bandages
About four in five cases of heel pain resolve within a year. However, feeling pain for this time can often be frustrating and uncomfortable. In about one in twenty cases, treatments are not sufficient and it may be necessary to resort to surgery to rehabilitate the plantar fascia.
Being overweight can cause excessive pressure and strain on the foot, particularly the heel. Losing weight and maintaining optimal weight by combining regular exercise with a healthy, balanced diet can be good for your feet. It is equally important to wear appropriate footwear, preferring shoes with a low or moderate heel that supports and protects the arch and heel. Avoid shoes without heels.
When to contact your family doctor
If the heel pain has been present for several weeks without showing improvement, it is advisable to consult your family doctor or a podiatrist (doctor who specializes in foot problems).The medical examination, together with the description of the ailments (symptoms) and the general state of health, present and past should be sufficient to identify the cause. Usually, further investigations are carried out only in the case of additional symptoms that may lead to suspicion of causes other than inflammation, such as:
- numbness or tingling sensation in the foot, both indicate nerve damage in the foot and leg (peripheral neuropathy)
- sensation of warmth in the foot and fever, could indicate a "bone infection
- stiffness and swelling of the heel, it could be a sign of arthritis
Your doctor may recommend blood tests, x-rays, MRIs, or ultrasounds.
Spread of heel pain
It is estimated that one in 10 people will suffer from at least one episode of heel pain at some point in their life. Individuals who run or jog regularly and those between 40 and 60 years of age are the two categories of people most affected by heel pain.