This is one of the most common complaints of pain in the foot. After 30 years of treating feet, I believe that almost any mechanical problem of the foot will eventually become heel pain. This is literally the “Achilles Heel”, on the back of the heel, and is the weak point of the foot and leg. Most heel problems can be treated conservatively with the proper foot orthotic device and stretching or strengthening exercises. This is a brief list of problems seen at the heel.
•Plantar Fasciitis: One of the most common causes of heel pain, it is caused by a straining of the plantar fascia. Plantar fascia is a connective tissue that forms a band between the heel bone to the ball of the foot on the bottom of the foot. Pain usually occurs at the spot where the heel and the arch meet. •Achilles insertional tendinosis: Pain where the Achilles tendon meets the heel bone •Heel Spurs: An extra spike of bone that grows near the heel and a band of connective tissue known as plantar fascia. Usually associated with a long standing case of fasciitis. •Bursitis: The swelling of a bursa, a fluid filled sac that reduces friction between a ligament and a bone. Possible anywhere, but common mid-central on the bottom of the heel. •Arthritis of associated joints •Injuries, including heel bone (calcaneous) fractures or sprains. •Many systemic disorders can lead to heel pain: 1.Rheumatoid arthritis or similar conditions such as gout 2.Neuropathy associated with diabetes, thyroid or other nerve disease 3.Obesity and excess activity
Treatment is best with the correct combination of therapies aimed at producing comfortable and pain free gait. A logical use of some or all of these therapies may be necessary: Orthotic devices, muscle stretching, shoe modification, NSAID pain medication, rest, injection, ECSWT (Non invasive shock wave therapy) or lastly surgery.