HEEL PAIN

(Heel Contusion; Heel Spur; Heel Bursitis)

 Basic information

description

Heel pain or heel discomfort can be caused by several conditions.

• Contusion or bruise of the heel bone. This causes inflammation of the tissue (periosteum) that covers the heel bone (calcaneus).
• Heel spur. A hard, bony sliver or needle that develops on the heel. It can cause inflammation and other problems in tendons and ligaments in the foot.
• Heel bursitis. This is inflammation of the connective tissue that surrounds a joint.

FREQUENT SIGNS & SYMPTOMS

Pain and tenderness in the heel and sole of the foot under the heel bone. Pain often occurs after resting or after rising in the morning. There may be no pain when sitting. One or both feet can be affected.

causes

Heel pain is usually a result of putting too much stress on the heel bone and the soft connective tissues (called the fascia) that attach to it.

risk increases with

• Running, jogging, or fast walking.
• Previous, or recent, foot or leg injury.
• Poorly cushioned shoes; lack of arch support.
• Prolonged standing; sciatica (leg nerve pain).
• Overweight.
• Walking barefoot on hard surfaces.

PREVENTIVE MEASURES

• Avoid activities that put constant strain on the foot. Switch to swimming or cycling.
• Wear a shoe with inserts.
• Wear athletic shoes with good shock support in the heels, good flexibility, and good support to control side-to-side motion.
• No more than 1.5-inch heels on everyday shoes.

expected outcomes

Usually curable with treatment. Different types of treatment work for different people.

possible complications

Soreness and arthritic changes in the heel that place extra stress on joints, such as those in the knee, hip, and spine.

 diagnosis & treatment

general measures

• Most people try self-care first. See your health care provider if the pain continues. A physical exam of the foot and ankle will be done. Questions will be asked about your symptoms and activities.
• Medical care may include physical therapy, casts, taping, night splints, injections, ultrasound, orthotics, or surgery. Treatment steps will depend on the symptoms.
• Use ice massage, or soak the heel in ice water. Do this for 15 minutes at a time, 3 or 4 times a day.
• Lightly massage the heel and calf before getting out of bed. Apply heat with a heating pad if it feels good.
• Taping helps some people. Apply athletic tape as directed on the product's instructions.
• Try heel cushions or lifts, arch supports, or medial wedge supports (available at sporting-goods stores and drug stores). Use products in both shoes so that other problems don't develop. Custom orthotics (inserts designed for an individual) may be helpful.
• Purchase shoes that fit well. Sandals help some people. Break in new shoes slowly by wearing them a few minutes per day to start.
• Stretching exercises will help.

medications

• To relieve minor pain, you may use ibuprofen or aspirin (adults only).
• Stronger anti-inflammatory drugs or injections of a steroid drug into the heel to reduce inflammation may be prescribed.

activity

Stay off your feet as much as possible, especially at the beginning of treatment.

diet

No special diet, unless you are overweight. If so, lose weight to reduce stress on the foot.

 notify our office if

You or a family member has heel pain that isn't helped by self-care.

Special Notes: