Heel Pain

Heel pain is one of the more common and debilitating conditions we regularly treat. It can occur on the bottom of the heel or on the back near the attachment of the Achilles tendon . The most common location is on the bottom of the heel on the inner side just behind your arch. It usually occurs in the over-40's age group, however pre-teenagers can get a different form of heel pain further back in the heel. There are no visible features on the heel.

The pain is usually worse on standing after a period of rest-particularly first thing in the morning when you get up or if you get up in the night to use the toilet. This is because the 5mm thick band of ligament-like tissue (the plantar fascia ) is stretched at its inflamed attachment to the bottom of the heel bone when you first bear weight. Although it is often associated with a spur of bone growing out of the heel bone ( heel spur syndrome ), approximately ten percent of the population have heel spurs without any pain. In fact, we often see them as an "incidental finding" on x-rays that are taken for other reasons than heel pain. Be aware that a "heel spur" is an x-ray diagnosis; therefore, it cannot be diagnosed with a quick clinical examination.

Heel bursitis can produce pain on the back of the heel near the attachment of the Achilles tendon to the heel bone. There may be a swelling on both sides of the tendon. There may or may not be a spur of bone growing out of the back of the heel bone. Again, this can only be determined with x-rays or MRI investigation. While an MRI will detect it, this is not necessary to make the diagnosis. If present, this may aggravate the overlying bursa so it becomes inflamed and painful.

In pre-adolescents (ages 10-12, more frequently males) heel pain is usually the result of traumatic (sports involving running or prolonged long-distance walking) disturbance to the growth plate on the lower back area of the heel. This is called calcaneal apophysitis.

To learn more about various treatments for heel pain, click here.