Heel Pain

What causes heel pain? 

The most common causes of heel pain are actually rather common injuries—Achilles tendonitis and plantar fasciitis. But there are multiple injuries and diseases that can cause pain in the heel. Some of these include":

Achilles tendon 

The Achilles tendon is a band of tissue that runs along the back of the ankle and connects the calf muscle to the back of the heel bone (calcaneus). Overuse and injury can result in Achilles tendinitis (inflammation of the tendon) or an Achilles tendon tear. 

Because of its location and connection to the heel bone, an Achilles tendon overuse injury can result in heel pain. Conservative treatments include physical therapy to strengthen the tendon, rest, and over-the-counter medications to reduce inflammation.

Arthritis 

Psoriatic arthritis, reactive arthritis, and rheumatoid arthritis can all cause joint pain. Psoriatic arthritis — arthritis associated with psoriasis — can specifically cause pain where ligaments connect to bones, such as where the Achilles tendon attaches to the heel. 

Rheumatoid arthritis is an inflammatory condition that targets the lining of your joints. 

Fortunately, there are multiple treatment options to reduce the impact of these types of arthritis and reduce patient’s pain.

Bone spurs

Heel spurs, also known as calcaneal spurs, are bony growths of the heel bone that form due to long periods of pressure, friction, or stress on the heel. Bone spurs themselves don’t often cause foot pain, but the pressure or friction they put on the surrounding soft tissue can cause inflammation or pain.

Anti-inflammatory medications like ibuprofen can relieve the pain caused by bone spurs by reducing soft tissue inflammation.

Calcaneal nerve entrapment 

The nerve in your heel can become trapped in the arch of your foot, resulting in pain throughout the ankle, heel, and arch of the foot. Many patients come to us having been misdiagnosed with plantar fasciitis only to discover the actual cause of their pain is nerve entrapment.

Ice and rest allow the nerve to heal while physical therapy can strengthen the tendons that surround the nerve. In severe cases, surgery can be used to release the trapped nerve and relieve your pain.

Haglund's deformity 

Sometimes called a “pump bump,” Haglund’s deformity is an enlarged bony bump at the back of the heel. High heels and shoes with tight backs can cause irritation and pain at the back of the heel. If left unaddressed, irritation from Haglund’s deformity can lead to Achilles tendinitis or heel bursitis.

Heel cups, orthotics, or properly fitted shoes are all treatment options to relieve pain from Haglund’s deformity. It is extremely rare for this condition to require surgical correction.

Heel bursitis 

Bursae are small fluid-filled sacs that cushion and protect your bones. Each of your feet has a bursa between the heel bone and Achilles tendon. Retrocalcaneal bursitis refers to irritation of the ankle bursa that results in heel pain. 

Osteomyelitis  

While not terribly common, bone infections (osteomyelitis) can also result in heel pain. This condition generally occurs in patients with chronic health conditions such as diabetes. 

Treatment requires antibiotics and severe cases may require full or partial amputation. It’s much easier to prevent osteomyelitis through regular examination of the foot. Catching small foot injuries before they become infected can prevent infection from spreading to your bones.

Plantar fasciitis 

Perhaps the most common cause of heel pain, plantar fasciitis is inflammation of the plantar fascia — the ligament that runs along the arch of the foot. Plantar fasciitis heel pain is characterized by stabbing pain in the bottom of the heel. Patients with plantar fasciitis often comment that their heels hurt in the morning or after a long period of rest. 

Plantar fasciitis is a common foot problem in patients with flat feet, as the ligament has to overstretch. Supportive shoes or arch support shoe inserts are often sufficient to relieve plantar fascia pain in its early stages.

Plantar warts 

Plantar warts are caused by HPV entering through tiny cuts or abrasions on your feet; they are common on areas of the feet that bear pressure—such as the heel. They can hurt when you walk or stand, causing you to change your gait or posture, which then leads to further discomfort in the ankle, feet, or legs. 

While plantar warts will go away eventually, our podiatrists are able to treat them from the comfort of our office. We have multiple options for treating or removing plantar warts to relieve your heel pain.

Sever’s disease  

This condition is a common cause of heel pain in active children between 8 and 14 years old. Despite its name, Sever’s disease is actually an injury of the growth plate at the back of the heel. Most children will outgrow the pain, but stretching exercises for the Achilles tendon can also help relieve pain.

Stress fractures 

People who begin an exercise routine too quickly or suddenly ramp up their activity level are at risk of stress fractures. Stress fractures are overuse injuries that result in tiny cracks in the bone. Running or jumping on hard surfaces without proper footwear can also put extra stress on your heels, resulting in stress fractures.

Tarsal tunnel syndrome

The tarsal tunnel is a passage of bones and ligaments in your ankle, your tibial nerve runs through this tunnel. Tarsal tunnel syndrome is a compression of the tibial nerve that can cause pain, numbness, tingling, or weakness in the foot. 

Pain can be managed with ice, rest, and over-the-counter pain medication, meanwhile braces or splints can hold the foot in place and allow the nerve to heal.

Other non-foot specific causes for heel pain include: ankylosing spondylitis, Paget's disease and sarcoidosis. 

How do the podiatrists at University Foot and Ankle Institute diagnose heel pain? 

In order to properly treat your heel pain, we need to uncover the root cause. Our consultation begins with a review of your medical history, questions about your current symptoms, and a physical examination of your feet and ankles. 

Our offices also have access to imaging technology such as X-rays and MRIs. With medical imaging, we can see the bones and soft tissues of your heel and look for injuries, fractures, and the condition of your tendons and ligaments. 

Once we’ve gotten to the root cause of your pain, our team will work with you to develop a treatment and pain management plan.

Why is UFAI the best choice for heel pain in the Los Angeles area? 

University Foot and Ankle Institute podiatry group is at the forefront of foot and ankle care and surgery. We offer a full level of care including conservative treatments, a spectrum of diagnostic imaging MRI and CT scanning services, and dedicated foot and ankle physical therapy.

University Foot & Ankle Institute is a nationally recognized expert in the treatment and correction of overuse injuries and foot deformities that result in heel pain. Our podiatrists are at the forefront of treatment and research and are committed to offering state-of-the-art surgical and non-surgical foot and ankle treatments. We regularly teach our techniques to foot surgeons throughout the world

By offering a full spectrum of workup, conservative, surgical, and recovery options, we are truly taking care of you in a state-of-the-art manner without the need to go from place to place.

To schedule a consultation, please call (855) 872-5249 or make an appointment now.

University Foot and Ankle Institute is conveniently located throughout Southern California and the Los Angeles area. Our foot doctors are available at locations in or near Santa Monica, Beverly Hills, West Los Angeles, Manhattan Beach, Northridge, Downtown Los Angeles, Westlake Village, Santa Barbara, and Valencia.