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Pain in your feet, and in particular, your heels can be incredibly debilitating, especially if it prevents you from walking properly.
If you suffer from heel pain, you are not alone, as it’s a very common condition. You might find that it builds up, and you will often notice that it’s only prevalent in one foot. This type of pain is usually at its worst first thing in the morning or if you’ve been sitting or lying down for a long time, and you might find that being mobile helps to lessen the pain. You could also try a foot support, so it isn’t too painful to put your weight onto the affected foot.
Pressures over time on our feet and heels can cause a thickening of the plantar fascia; this is the name of the tissue band which is underneath your feet. It’s extremely tough and flexible but can develop tears or damage, either over the years or as the result of a sudden injury.
If you’re suffering from heel pain, you can visit your doctor or foot specialist, known as a podiatrist, who will examine your feet and try to ascertain the root cause of your problem.
Heel pain is uncomfortable, to say the least, but that’s not to say you have to live with it. You can help to relieve your pain and aid recovery by following a few simple tips:
Make sure your shoes fit properly and have a good level of support and cushioning
Rest your heel and don’t walk too far or for too long
Use a good support or strap for your foot
Take pain relief such as non-steroidal anti-inflammatories, or use an ice pack
Stretch your calves regularly
Usually your heel pain will disappear, although around 5% of cases will need surgery.
As well as following the above advice for relieving your pain, there are some things you can do to help yourself in preventing it from occurring in the first place. It’s always a good idea to stay at a healthy weight for your height, so a balanced diet and plenty of regular exercise will work wonders (this applies to your overall health and not just your feet). It’s also very important to make sure you are wearing the right type of shoes or other footwear, avoiding high heels and shoes without any heels, and opting for choices with plenty of support and cushioning.
Heel pain can be very frustrating and inconvenient when active. The root cause of heel pain can be from a variety of conditions, of which plantar fasciitis is probably one of the most common and accounts for about four in five cases. Other conditions contributing to heel pain include stress fractures, bursitis and tarsal tunnel syndrome.
The condition plantar fasciitis is used to describe damage to the plantar fascia, which is the thick band of tissue connecting the heel and the foot. When this becomes either damaged or thickened then a patient will typically experience pain and discomfort in the heel region.
The condition can be brought on from either a sudden injury or from gradual wear and tear which is more common amongst the over forty demographic. A sudden injury can occur when active, where damage to the heel is caused as a result of running and even dancing and is more common amongst the younger demographic.
There can be an increased risk of plantar fasciitis for those who are overweight, have a job requiring long periods of standing up or from wearing flat shoes. These elements can contribute to the degradation of the plantar fascia leading to problems in later life, which is why it is always important to look after yourself, stay fit and wear appropriate footwear.
Typically as a result of impact damage a stress fracture occurs where there is damage sustained to the heel bone. This can occur as a result of landing awkwardly or from a height or from an impact such as a football challenge.
This can be very painful and may require surgery to remedy the problem leaving you immobile for a greater period of time.
Beneath the heel there is a layer of fat referred to as the fat pad. Heel pain occurs where this layer begins to wear away and reduce the amount of cushioning in the heel, thereby causing pain. This condition is gradual and typically experienced by wearers of high heel shoes, where too much pressure has been placed on the fat pad in the first instance.
A bursa is a small fluid-filled sac which reside under the skin between bones and tendons throughout the body. Bursitis occurs where these sacs become inflamed, thereby restricting movement of the joint and causing the patient pain. The condition itself can be experienced in any joint throughout the body, with the heel and elbow the more common places.
Tarsal tunnel syndrome is a nerve damage related condition. The nerves from the sole of your foot are connected to the ankle joint through a small tunnel referred to as the tarsal tunnel, with any damage sustained to this tunnel leading to compression of the nerves which can be the root cause of pain experienced by the patient.
The nerves within the foot cover a large area, therefore the pain can be centred at any point from the sole of the foot to the heel to around the ankle joint.
Sever’s disease is typically a children’s condition as a result of a combination of growth spurts and sports activities which stretch and tighten the tendons within the hamstring and calf. A stretching calf muscle pulls on the Achilles tendon which in turn pulls on the growth plate on the back of the heel, thereby causing the patient pain.
Where a patient complains of numbness or a tingling sensation within the foot it could be a sign of peripheral neuropathy or nerve damage and you may be referred to a specialist for it to be investigated before an official diagnosis is given.
The symptoms of a bone infection is a high temperature in the actual foot, seeing temperatures of 38 degrees and above and typically considered as a fever. Osteomyelitis, as it is referred to medically, is typically caused from bacteria resulting in a high temperature, pain in the actual bone and swelling and inflammation of the affected area.
If your complaint of heel pain is through stiffness and swelling of the heel area then the root cause of the issue could be arthritis. You may be sent for further tests including an X-ray before this is determined, from which there are a variety of treatment options available to help manage the condition and enhance your levels of activity.
People with pain in their heel normally get better within a year and only 5% of people with the condition will require surgery. Pain can be relieved and recovery aided by a combination of different treatments such as analgesics and stretches.
The treatment option for heel pain depends on your diagnosed condition, with options covering rest, physiotherapy, a foot support or even surgery. If you are unsure as to the extent of your injury then you should seek clinical advice for a professional diagnosis.
A foot support is used to help manage some forms of heel pain such as plantar fasciitis. A night splint or foot support can be used to immobilise the foot and ankle while you sleep, whilst still offering comfort across the extensor tendons. It works by offering gentle stretching of the plantar fascia over the full range of the ankle. The same device can be used for other lower extremity conditions and Achilles tendonitis.
If you are unsure as to the nature of an injury or condition then you should seek clinical advice to obtain a professional diagnosis. On visiting your doctor or a podiatrist you will be asked a series of questions pertaining to your complaint in a bid to identify the root cause of the issue, as well as assessing the area first hand.
In the majority of cases your doctor or podiatrist will be able to identify your condition at the initial consultation and offer their advice on how this might be treated best, whether in the form of physiotherapy, rest or the use of a foot support.
There are instances however where the condition may not be diagnosed in the first instance and further analysis is required to understand the root cause of the problem.
It is important to rest your foot if you have heel pain. Avoid standing up for long periods or walking long distances. Avoid wearing flat shoes as these may not offer enough foot support. Although you need to rest, stretching exercises for your feet and calves such as those described below, should be carried out regularly.
Pain can often be relieved by taking painkillers such as ibuprofen or other NSAIDS (non-steroidal anti-inflammatory drugs). Some people rely on ice packs to reduce inflammation and provide pain relief. These can be applied to the affected area for 5 to 10 minutes. If your ice pack does not have a cover, wrap it in a towel so it is not directly in contact with the skin. A packet of frozen peas makes a good substitute if you have no ice pack.
Your heel pain should be reduced by exercises that stretch your calf muscles and the tissue underneath your sole (the plantar fascia). You should exercise both legs to help with stability and balance even if you only have pain in one heel. Various stretches can be practised when lying down, standing and even when sitting in a chair. It is important to exercise regularly at least twice a day. Your physiotherapist will prescribe specific exercises for your condition and tell you how frequently you should undertake each one.
These are insoles that are worn inside the shoe to provide support. They can be bought off the shelf or custom made.
Strapping which you can learn to apply yourself can help to relieve heel pressure. Another solution is to use night splints to keep your toes pointing up at night. This prevents tissue inside the heel being squeezed together and has the effect of stretching the plantar fascia and the Achilles tendon, thus helping with recovery. Lightweight night splints are available from specialist online retailers.
If your pain fails to respond to the above treatments your GP may consider corticosteroid injections to reduce the inflammation.
You may be referred for surgery if you still have heel pain after a year. There are different surgical options which can be discussed with your surgeon prior to the operation. There is also a new treatment known as extracorporeal shockwave therapy, or EST, which is non-invasive but it is not yet commonly used. However, most pain can be relieved through a combination of analgesia, exercise and foot support.
For conditions relating to the heel and helping to manage heel pain it can sometimes be difficult to prevent, though as with most injuries there are a number of ways of minimising the risk which include the need to maintain a healthy weight and having healthy feet through the use of appropriate footwear.
Simply put, the heavier you are the more weight is placed on your joints and in particular your feet and therefore increases the risk of heel pain along with other conditions. If you are suffering from heel pain then losing weight and undertaking exercise can have a positive impact on your lifestyle in general and on your mobility.
If you are unsure if you are overweight or not then you should work out your BMI (Body Mass Index) which divides your weight in metres by your height in metres squared to offer an indication.
Less than 18.5 is underweight
18.5 – 24.9 is a healthy weight
25-29 is overweight
30-40 is obese
Over 40 is morbidly obese
To calculate your BMI easily try a BMI Calculator.
Based on your BMI you can make decisions on your lifestyle and eating habits.
Footwear is an important factor in giving you healthy feet as the wrong footwear for the wrong occasion can cause injury and heel pain. You would never go hiking wearing a pair of flip flops, likewise you would never go running in a pair of hiking boots which is why it is important to select footwear designed for your specific task.
Women’s footwear is something which will always be highlighted where heel pain is concerned and whilst the use of high heels sparingly can have little impact on your feet, constant use can lead to problems and heel pain from a number of conditions. The condition can be worsened from continual walking or standing when wearing high heels.
Sports shoes are designed to offer protection of the foot and cushioning, which is essential when running on hard surfaces. It is recommended however that you should replace your shoes every 500 miles to ensure that they continue to give you to right level of protection. The majority of sports shops will assess your running style to offer you the right style of shoe to ensure you are fully protected which can help to minimise the risk of injury.