Heel pain is generally the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. The stress may also result from injury, or a bruise incurred while walking, running or jumping on hard surfaces; wearing poorly constructed footwear or excessively worn shoes, or being overweight.

A common cause of heel pain is the heel spur, a bony growth on the underside of the heel bone, visible on x-ray. When there is no indication of bone enlargement, the condition is sometimes referred to as “heel spur syndrome.” Both heel pain and heel spurs are frequently associated with an inflammation of the ligament-like band that runs from the heel to the ball of the foot, called plantar fascia. The purpose of this ligament is to help support the arch of your foot.

Heel pain is one of the leading causes that patients visit Dr. Kostadinka Skandeva to have treated.

Plantar fasciitis (inflammation of the plantar fascia) starts as a dull intermittent pain in the heel, which may progress to a sharp persistent pain. Classically, it is worse in the morning with the first few steps, after sitting, after walking or standing for long time. The pain usually gets better after walking around for a while as the tissue “loosens.” The reason the pain is worse in the morning is because the plantar fascia has had the chance to contract (shorten/tense up) all night long while you were sleeping. The pain can be described as a sharp pain (like stepping on a pebble, needle) or a dull aching/throbbing pain.

There are many treatments for heel pain. The most common conservative (non-invasive) heel pain treatment options include but not limited to are: rest, ice, stretching exercises, anti-inflammatory medications, steroid injections, taping, strapping, immobilization, physiotherapy, night splints, custom or pre-fabricated orthotics (arch supports), heel cushions, weight loss.

A majority of people do respond to conservative therapy, and only small subsets of individuals require more aggressive intervention such as surgery. It doesn’t help that the fascia doesn’t heal particularly quickly. This is because it has relatively poor circulation. It is known that the sooner you begin treatment the more likely that the problem will respond to treatment.