What Can Help Ease Heel Pain?

Heel pain is uncomfortable, although not normally a sign of anything serious. However, it can make everyday activities difficult, such as walking, running or climbing stairs, and in rare cases it can be caused by a stress fracture or a condition that requires further investigation. We recommend seeking medical help if you are experiencing heel pain that is impacting your daily life and not settling with some rest and time, so you can understand more about the causes and possible treatment options.

• Achilles tendinitis – This is particularly common in runners and athletes and is often associated with a sudden increase in training intensity or duration, resulting in an overuse injury. The Achilles tendon is a band of tissue at the back of the lower leg that connects the heel bone to the calf muscles. Although most cases don’t require surgery, if you tear your tendon (Achilles tendon rupture) you need to be reviewed and have appropriate treatment; either in a specialist boot or you may need to undergo a surgical repair.
• Stress fractures – These are tiny cracks in the bone and are often the result of overuse. They can also be caused by osteoporosis, which leads to a weakening of the bone. You may be at risk of a stress fracture if you do too much too soon when you embark on an exercise regime. The pain of a stress fracture tends to worsen over time and you may also notice swelling or bruising.
• Rheumatoid arthritis – This is an autoimmune condition that causes your body’s immune system to mistakenly attack its own tissues. It can produce a wide range of symptoms, including heel pain. As the condition develops it causes painful swelling and can result in joint deformity. It can also affect the organs, blood vessels and nerves. It’s important to see a doctor particularly if you have a family history of rheumatoid arthritis.
• Psoriatic arthritis – Psoriatic arthritis affects certain people who have psoriasis, a disease that causes dry, red patches on the skin. It produces symptoms that worsen over time and can include foot pain in the sole of the foot or the back of the heel. Other common symptoms are swollen fingers and toes, lower back pain and eye inflammation. If you have psoriasis and develop heel or joint pain, see a doctor.
• Reactive arthritis – This form of arthritis is triggered by some kind of infection, most commonly in the urinary tract, genitals or gut. Reactive arthritis can cause pain and stiffness in the heels, as well as the knees, ankles, lower back or buttocks. It may also cause urinary problems. Reactive arthritis is uncommon and symptoms generally get better by themselves within 12 months.
• Bursitis – The bursae are fluid-filled sacs that cushion the muscles, tendons and bones near to your joints. They are most common in the shoulder, hip and elbow but you also have bursae in your heel and around most weight-bearing joints. If they become inflamed the area may feel stiff, painful and appear swollen.
• Other possible causes of heel pain include heel spurs, ankylosing spondylitis, plantar warts or even very rarely, a bone tumour.

If you are experiencing heel pain your doctor will carry out a physical examination and ask you about your symptoms and medical history. They may send you for an X-ray or MRI scan to rule out a stress fracture and confirm the diagnosis.

The treatment recommended will depend on the cause and severity of your heel pain. If you have plantar fasciitis, for example, your doctor may recommend physiotherapy. You will be shown exercises to help stretch the plantar fascia and Achilles tendon and strengthen your lower leg muscles. You may need to wear orthotics in your shoes to distribute the pressure on your feet more evenly or night splints which hold the Achilles tendon and plantar fascia in a lengthened position while you sleep to promote stretching. In some cases, you might be offered a steroid or a  platelet rich plasma injection to promote healing or rarely surgery to debride the diseased plantar fascia from the heel bone. Once your medical team has determined what is causing your heel pain they will discuss the most suitable treatment plan with you.

Effective at-home treatments including applying an ice pack to the affected area for 15 minutes several times a day or rolling a bottle of frozen water under your foot. Painkillers and anti-inflammatories can help to ease the symptoms.