Heel pain is a frequent health problem that affects almost everyone at some point or another. It can occur in people of all walks of life and even occur in athletes. Surprisingly, heel pain is becoming more common and has risen to one of the most common causes of foot related complaints (Agyekum & Ma, 2015). More than just affecting how one walks, heel pain can limit activities of daily living thereby affecting a person’s quality of life. In today’s fast paced world, it is increasingly important for us to understand heel pain and address it before it is too late.
There are a number of possible causes for heel pain. By far the most common cause of heel pain is a condition known as plantar fasciitis. Plantar fasciitis is an inflammation of the plantar fascia. The plantar fascia is a band of tissue that runs along the bottom of the foot, supporting it throughout the day. In the majority of cases, the pain is localized in the heel and tends to be severe in the morning or following a period of rest. It is easily distinguished from other forms of heel pain by its distinctive “stinging” quality. Heel fat pad syndrome is another frequent cause of pain in the heel, characterized by a thin or damaged fat cushion, often resulting in more pain for the individual when they walk or are on their feet. A number of overuse injuries can also be the cause of heel pain. These are commonly experienced by athletes, particularly runners, or anyone who have recently increased the level or frequency of their activity. The increased stress and resulting strain on the heel cause discomfort and can lead to lameness (Chang et al., 2022).
Heel pain can have a significant impact on an individual’s lifestyle. It can be so bad that walking, standing or exercising could become painful tasks that limit activity. People with heel pain often make lifestyle changes to avoid activities that they used to enjoy, such as running or walking. If left untreated, heel pain can cause discomfort that radiates to other parts of the body, such as the knees or back. Addressing heel pain early on is vital in preventing the pain from negatively affecting a person’s overall health and wellbeing. In the past, conservative treatment for heel pain has been designed around a patient’s activity level, but according to Tu (2018), this approach may not be enough.
In addition to treating heel pain, we can help you prevent it too! Our experts can show you how to select the right shoe, perform simple foot and calf stretches, and exercise properly. By increasing activity gradually and performing certain exercises, you can reduce your risk of developing heel pain. By taking a few simple steps, you can prevent heel pain and maintain your active lifestyle. Heel pain has a multitude of symptoms, making everyday tasks painful. You may experience a sharp or stabbing pain in your heel when you stand up for work after a long night’s sleep, or when you step onto the gas to get to work on time. You may also feel pain when you start to walk after sitting for a long time. Additionally, many people with heel pain experience swelling around the back of their heel. While many people may experience a slight ache in their heel from time to time, for millions of people, heel pain can affect their ability to perform even the simplest tasks, such as getting out of bed in the morning, or walking from your car to the grocery store. Studies have shown that people with heel pain are at risk for missing out on other activities they normally would do (Rosenbaum et al., 2014, Bhatty et al., 2019).
Heel pain is an issue that could be stopping you and/or your patients from the activities and life that you enjoy. People with heel pain may avoid things like jogging or running due to fears that they could worsen their pain. Although in the short term avoiding activities with heel pain is appropriate in order to prevent further pain, in the medium term it could lead to individuals becoming less active and becoming less fit. This avoids the issue but is not a sustainable solution and means that simple things such as shopping, standing at work for periods of time, attending parties or activities, watching TV on the floor, all become difficult if not impossible to do. This inability to do things that most people would take for granted can have a negative effect on overall quality of life.
The impact of chronic heel pain on mental health cannot be ignored. The anxiety caused by pain can make individuals afraid to engage in activities that they know will cause pain but dreaded all the same. The worry about pain can increase stress and tension in the heel causing more pain. In addition, people with chronic heel pain may become depressed. They may withdraw from social activities, missing out on time with family and friends, feeling sad, blue, or hopeless. They may be unable to participate in activities they once enjoyed, due to pain (Lareau et al., 2014).
When suffering from heel pain most people focus on the physical symptoms. They may not be aware of how heel pain can also affect a person’s mental and emotional well being. Heel pain can be so debilitating to daily activity that sometimes treatment begins before a correct diagnosis is even made. Learning the symptoms and the possible effects can empower a patient to demand proper care and initiate an effective course of treatment. In addressing the many potential causes of heel pain, there are several commonly used methods of treatment. Most begin with conservative methods to manage pain, with more invasive options reserved for patients with severe and persistent cases. Many of these options focus on re-balancing the mechanics of the foot. This is often achieved by using over the counter or custom-made orthotics, or by utilizing a variety of modalities in a physical therapy setting to perform exercises designed to strengthen the muscles surrounding the heel. Simple things like stretching the calf and the plantar fascia can make a big difference in relieving heel pain. Mild cases of heel pain and plantar fasciitis can also be alleviated with ice therapy and over-the-counter pain relievers.
In some cases, your doctor may order certain shoe inserts, special shoe designs or physical therapy in attempt to manage pain and aid in recovery. When these conservative approaches fall short, however, your doctor may recommend a surgical approach to remove bone spurs, release tension on the plantar fascia or repair other affected tissues in your foot (Salvioli et al., 2017; Babatunde et al., 2019). Prior to making this leap, however, make sure you fully understand the possible risks and benefits.
Prevention of heel pain is as important as treatment. Many cases of heel pain can be avoided with a few simple changes to lifestyle. Wearing appropriate footwear is one way in which people can avoid many common heel problems. Shoes with good arch support and padding can help protect the heel and reduce the chances of developing a heel problem. High heels, stilettos, narrow footwear, and shoes which are worn with inadequate footwear such as socks or insoles can all potentially cause problems for the heel by placing too much strain on the area.
Although a good pair of shoes is important in preventing plantar fasciitis, stretching can also play a huge role in preventing the condition. Stretching the calf muscles and the Achilles tendon can help keep both tissues long and pliable, preventing them from putting pull on the heel. Tu (2018) along with other researchers found that stretching the two muscles helps to reduce tension in the heel. Agyekum & Ma (2015) both also recommended stretching the calf and Achilles. Performing simple stretches such as the wall stretch or towel stretch for a few minutes a day can go a long way in keeping your plantar fascia healthy and can even help to prevent heel pain.
Awareness and education of heel pain is key to its proper management and to improve the lives of individuals affected by it. Knowing about the causes of heel pain and measures to prevent or reduce its severity empowers individuals to take protective steps for their feet. Awareness also empowers individuals to identify warning signs of heel pain early and seek treatment before the condition worsens. The public should have access to resources explaining heel pain, and how appropriate foot care, good footwear and exercise can help to reduce pain. Knowledge of these factors can empower individuals to take care of their feet to live healthy active lives (Bhatty et al., 2019; Rio et al., 2015).
Citations:
Agyekum, E.K. and Ma, K., 2015. Heel pain: A systematic review. Chinese Journal of Traumatology, 18(03), pp.164-169. https://mednexus.org/doi/abs/10.1016/j.cjtee.2015.03.002
Tu, P., 2018. Heel pain: diagnosis and management. American family physician, 97(2), pp.86-93. https://www.aafp.org/pubs/afp/issues/2018/0115/p86.html
Rio, E., Mayes, S. and Cook, J., 2015. Heel pain: a practical approach. Australian family physician, 44(3), pp.96-101. https://search.informit.org/doi/abs/10.3316/informit.976563839782466
Rosenbaum, A.J., DiPreta, J.A. and Misener, D., 2014. Plantar heel pain. Medical Clinics, 98(2), pp.339-352. https://www.medical.theclinics.com/article/S0025-7125(13)00157-0/abstract
Bhatty, U.N., Khan, S.H. and Zubairy, A.I., 2019. Managing the patient with heel pain. British Journal of Hospital Medicine, 80(4), pp.196-200. https://www.magonlinelibrary.com/doi/abs/10.12968/hmed.2019.80.4.196
Lareau, C.R., Sawyer, G.A., Wang, J.H. and DiGiovanni, C.W., 2014. Plantar and medial heel pain: diagnosis and management. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 22(6), pp.372-380. https://journals.lww.com/jaaos/fulltext/2014/06000/plantar_and_medial_heel_pain__diagnosis_and.5.aspx
Chang, A.H., Rasmussen, S.Z., Jensen, A.E., Sørensen, T. and Rathleff, M.S., 2022. What do we actually know about a common cause of plantar heel pain? A scoping review of heel fat pad syndrome. Journal of Foot and Ankle Research, 15(1), p.60. https://link.springer.com/article/10.1186/s13047-022-00568-x
Salvioli, S., Guidi, M. and Marcotulli, G., 2017. The effectiveness of conservative, non-pharmacological treatment, of plantar heel pain: a systematic review with meta-analysis. The Foot, 33, pp.57-67. https://www.sciencedirect.com/science/article/pii/S0958259217300615
Landorf, K.B., 2015. Plantar heel pain and plantar fasciitis. BMJ clinical evidence, 2015, p.1111. https://pmc.ncbi.nlm.nih.gov/articles/PMC4661045/
Babatunde, O.O., Legha, A., Littlewood, C., Chesterton, L.S., Thomas, M.J., Menz, H.B., Van Der Windt, D. and Roddy, E., 2019. Comparative effectiveness of treatment options for plantar heel pain: a systematic review with network meta-analysis. British journal of sports medicine, 53(3), pp.182-194. https://bjsm.bmj.com/content/53/3/182.abstract
University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger, dad.
