The heel is the part of the foot that typically strikes the ground first when walking or running, and as a result, the bone, tendons, ligaments, and other tissues in this area are subjected to substantial pressure and repetitive impacts throughout the day. Heel pain can develop whenever any of these structures are irritated, injured, or inflamed. Some common causes of heel pain include plantar fasciitis, heel spurs, heel bursitis, arthritis, and Achilles tendonitis.
Bursae are small, fluid-filled sacs that help joints remain flexible and resilient, reducing friction when the joint is moved. Sometimes, these tiny sacs become irritated or inflamed, resulting in a condition called bursitis. Heel bursitis affects the bursa located between the heel and the Achille's tendon. In most cases, bursitis can be treated with medication, ice, rest, and compression.
Heel spurs are bony overgrowths that form as a result of calcium deposits building up along the edge of the heel bone. While many heel spurs cause no symptoms, some press into the surrounding soft tissues, making movement painful. Symptoms usually can be relieved with custom orthotics designed to relieve pressure on the area. In a few cases, surgery may be needed to remove them.
Because so many structures can be involved in heel pain, the first step in treatment is to perform a careful evaluation of the heel, ankle, and foot using passive and active exercises, “hands-on” and visual exams, and diagnostic imaging when needed to evaluate the joint and other internal structures. Once the source of pain is determined, treatment options can include:
Seeing the podiatrist at the first sign of pain can prevent an underlying issue from becoming worse.
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