Heel pain is one of the most common conditions we see here at Castle Orthopaedics and for some people it can be debilitating. It is believed that around one in 10 people will experience heel pain during their life, most often people aged between 40 and 60 years of age and people who jog or run regularly.
Symptoms of heel pain
It is most often experienced as a sharp pain in the affected heel which worsens over time. The pain is normally more intense when you walk or stand after a period of sitting or lying down. It may improve when walking but tends to become more severe when standing or after walking for any length of time. For most people the pain affects one heel although it is believed that up to a third of people have pain in both heels. Trying to avoid walking on the affected heel may lead someone to develop an abnormal walking style.
What causes heel pain?
Heel pain is most often caused by damage to the plantar fascia, a band of tissue that runs under the sole of the foot, connecting the bones of the foot with the heel bone and acting as a shock absorber when you walk or run. The plantar fascia is tough and flexible but it can become damaged over many months or years causing microtears, or it may be subject to sudden damage as the result of an injury. This can cause the tissue to thicken and the surrounding tissue and heel bone may become inflamed.
Other possible causes of heel pain include a sprain or strain, a fracture, Achilles tendonitis which is inflammation of the Achilles tendon, or bursitis which is inflammation of the bursae (fluid-filled sacs that cushion the joints).
Diagnosis of heel pain
Your doctor will carry out a physical examination and assess for cysts, stress fractures or nerve problems in the heel. You may need imaging scans or blood tests to confirm the diagnosis.
Treatments for heel pain
Most people who suffer from heel pain will recover within a year. However, for some people the condition may become chronic (long-term and ongoing) and for 20% of people (around one in 20) the problem may require surgery to release the plantar fascia.
If you have mild symptoms, simple treatments like these may be enough to relieve the pain and support your recovery:
- Rest the heel and don’t stand for long periods or walk for long distances.
- Wear shoes that support the arches of your feet and cushion the feet properly. Flat-soled shoes may make the pain worse.
- Take anti-inflammatory medication and use ice to sooth inflammation on the affected heel.
- Stretch the plantar fascia and calf muscles. Try looping a rolled-up towel around your foot and pull your toes towards your body, keeping your knees straight. Stand on one step of your stairs holding the bannister and keeping your feet slightly apart with the heels hanging over the back of the step. Lower the heels until you feel the stretch in your calves. Hold for 30 seconds. Make sure you exercise both feet to improve stability and balance.
- Use orthotics inside your shoes or strapping with sports tape to support the heel. Orthoses are insoles that fit inside your shoe to support your foot and help your heel recover. Night splits that keep your toes pointing down while you sleep can also help.
For more serious heel pain, you may be offered injections of corticosteroids to reduce inflammation and relieve pain or extracorporeal shockwave therapy (EST) which uses high energy soundwaves to numb the nerves and stimulate healing. It is normally carried out under local anaesthetic.
Surgery for heel pain
If more conservative treatments fail to provide sufficient relief you may require plantar release surgery. This is done as a day case and can work well for people who have failed to progress with non operative treatments. Your orthopaedic surgeon will discuss the most suitable option for you.
If you are experiencing heel pain and would like advice about diagnosis and treatment options, contact Castle Orthopaedics.
Orthopaedic specialists – Nottingham
Our orthopaedic consultants each specialise in a particular area of orthopaedics, giving you added peace of mind that you are receiving expert medical advice and highly tailored treatment.
BMI The Park Hospital
Sherwood Lodge Drive Burntstump Country Park, Arnold NG5 8RX
Spire Nottingham Hospital
Tollerton Ln, Tollerton, Nottingham NG12 4GA