Pain in the heel of your foot can be brought about by a myriad of issues and some of those include plantar fasciitis, infection in your heel bone, fracture of your heel bone and neurovascular disturbances in the leg or foot.
This article may be more biased towards pain secondary to plantar fascitis.
After walking or standing for long periods, you may experience heel pain by the end of the day. This commonly happens due to the acute inflammation of the ligaments and muscles around the heel.
causes of heel pain
Conditions that bring about heel pain are normally long standing and can affect your daily life.
- Neurologic causes
Neurological causes of heel pain stem from impingement of nerves in the foot. forinstance impingement of the posterior tibial nerve in the foot leading to tarsal tunnel syndrome. You will experience a burning sensation in the foot worsened by upward movement of the foot.
2. Causes as a result of the soft tissue problems in the foot
Below is a rundown of the soft tissue conditions that will cause heel pain.
- Fat pad atrophy that is most common in the elderly.
- Fat pad contusion that can occur after a heavy landing.
- Achilles tendinitis; secondary to inflammation in the Achilles tendon as a result of injury, infection or degeneration.
- Retrocalcaneal bursitis. Inflammation of the pockets at the back of the heel bone.
- Posterior tibial tendinitis. This tendon can be inflamed anywhere along it’s course.
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3.Skeletal Problems
- This mostly occurs following an injury to the heel bone like an acute calcaneal fracture or a stress fracture.
- Rheumatoid athrititis. Aside from having pain in multiple joints, they may also have heel pain.
Risk factors of plantar fasciitis
| Risk factors inside the foot | Risk factors outside the foot |
| – Flat foot -High arched foot -Shortened Achilles tendon -Weakness in the muscles of the foot | -walking barefoot – Standing for long periods. -Inadequate stretching -Poor foot wear |
Treatment of heel pain
- Determining the cause the heel pain.
This can be identified from a clear history , examination and very rarely radiological investigations like X-Rays.
- Wear the right foot wear. Shoes without cushion can act as pressure points and hence lead to heel pain.
- Lifestyle modification. weight loss can play a role in reduction of heel pain.
Care specific to the foot
Immediate care.
- Put an icepack around the heel. The ice is used to reduce the inflammation around the heel.
- Soak your feet in warm water. The warm water improves the blood flow in the feet and this eases the delivery of nourishment and oxygen to the tissues in the foot.
- Wear shoe inserts as these will cushion the heel.
- Over the counter painkillers will help though be aware of the side effects some of these carry.
Daily foot exercises
In the literature, these plantar fasciitis exercises have been shown to have the best long term outcome in the management of plantar fasciitis.
Physiotherapy can be prescribed and its role is to strengthen the muscles in your foot and calf while while increasing flexibility so that they can withstand any type of work.
- Calf and arch stretch exercises.
How it is done: Using a towel or a scarf, pull your foot towards yourself before going to bed ans upon waking up before you step down. Do 4 repetitions each lasting 30 seconds and release.
- Roll plantar fascia with a ball or bottle.
How it is done; Place a ball or a bottle beneath your feet roll back and forth. Set a timer for one minute or count to 60. Take a 30 second break between each set. Do this twice daily, before bed and before you step down in the morning.
- Manual plantar fascia stretch.
Cross your foot over your thigh and use the same side hand to pull down the toes while the index and middle finger of the other hand massage down over the length of the foot. do this for 3 minutes with 30 seconds interruptions.
Use of ankle foot orthosis for plantar fascitis
Ankle foot orthosis is worn in the night to keep the foot in the desired dorsiflexion angle. These splints have been said to be extremely effective in pain management of heel pain in plantar fascitis.
Other modalities that are used to alleviate heal pain include surgery.
In conclusion, heel pain can arise from a multitude of causes. There is need for good evaluation in order to determine the primary cause as this will guide the mode of treatment.
