Heel Pain

What is heel pain?

Heel pain is among one of the most common chief complaints encountered in a podiatrist office. The heel is a unique structure with multiple areas of ligamentous, tendinous and neurovascular structures in close proximity which can sometimes make diagnosing the cause of heel pain challenging. Generally, most of our patients with heel pain will describe their discomfort as being worse with first steps in the morning, difficulty standing for prolonged periods of time and swelling/aching pain at night time. Heel pain can have an acute onset or it can be ongoing for years if not adequately treated and addressed by a podiatrist.

Diagnosis

Your physician will obtain x-rays of your foot to assess the underlying bony architecture to ensure no underlying fractures. Occasionally, bone spurs will be visualized however these are usually not the underlying cause of pain. A full comprehensive exam will then be performed in order to elucidate the underlying pathology and cause of your pain. Conditions that can potentially be causing your heel pain include:

  • Plantar fasciitis
  • Haglund’s deformity
  • Nerve entrapment
  • Calcaneal fracture
  • Bone tumor

Occasionally, advanced imaging may be obtained if pain has been ongoing and worsening for several weeks/months in order to assess the underlying soft tissue structures in greater detail.

Conservative Treatment

Heel pain is almost always addressed conservatively depending on the diagnosis. The literature even supports this fact, indicating that 90-95% of patients with heel pain have complete resolution with conservative treatment. Your physician will develop a comprehensive plan that will address your heel pain and fit with your life-style, however the most common conservative treatment modalities may include:

  • Rest, ice, compression and elevation
  • NSAIDS or a Medrol steroid dose pack taper
  • Custom orthotics/Night splint
  • Contrast bath therapy
  • Physical Therapy
  • Corticosteroid injection/PRP injection

Surgical Treatment

If your heel pain has been recalcitrant to conservative treatment, your physician may consider surgical intervention in order to alleviate your pain. It will all depend on the underlying cause of your heel pain.