How Do I Get Rid of The Pain in My Heel?

Reviewed on 11/5/2020

What Causes Heel Pain?

Heel pain can have multiple causes, but almost universally rest, ice and NSAID pain relievers are included in treatment suggestions.
Heel pain can have multiple causes, but almost universally rest, ice and NSAID pain relievers are included in treatment suggestions.

Heel pain accounts for 11 to 15 percent of all visits to foot and ankle surgeons. There are numerous causes of heel pain. Pronated foot strike, excessive shoe wear, prolonged standing on hard surfaces, sports activity, and a higher body mass index are among factors that may cause heel pain.

Chronic conditions that cause heel pain include: 

  • Plantar fasciitis
    • One of the most common causes of rear foot and heel pain caused by repetitive impact to the heel and plantar fascia by activities such as running, marching, or dancing
  • Tarsal tunnel syndrome 
    • Results from compression of a nerve
  • Achilles tendon insertion and Haglund deformity
    • Often develops in distance runners and athletes involved in running and jumping sports, as well as people who do a lot of walking, hiking, or stair climbing
  • Piezogenic papules
    • Nodules that result from minor herniations of the fat pad through the capsule of connective tissue that surrounds the heel bone (calcaneus)
  • Subtalar arthritis 
    • May be caused by anatomic malalignment, leg-length inequality, and secondary arthritis from trauma following fractures

Overuse tendon conditions that cause heel pain include:

  • Flexor hallucis tendinopathy 
    • Injury occurs during activities that entail excessive stress during toe-off, such as ballet dancing 
  • Acute Achilles tendinopathy
    • Sprinting, running hills, or excessive jumping may inflame the Achilles

Traumatic conditions that cause heel pain include:

  • Heel contusion (also called heel pad or foot pad contusion)
    • Caused by acute trauma (e.g., landing from high fall), stepping on a root or rock during trail running, or chronic overuse (e.g., distance running in shoes with inadequate heel cushion)
  • Calcaneal and talar stress fractures 
    • Usually related to a history of high-intensity activity, often running but sometimes hiking or other sports

Medical conditions that can cause heel pain include:

How Is Heel Pain Diagnosed?

The cause of heel pain is diagnosed with a history and physical exam. A doctor will ask when and how the pain started, and will palpate the foot and heel to determine where on the foot the pain is located. They will also observe if there is swelling, redness, or warmth of the affected area and note any deformities that may be present.

They will also check for systemic symptoms such as fever or chills, weight loss, prolonged morning stiffness, swelling or pain in other joints, prior history of cancer, long-standing chronic disease, history of sickle cell anemia, and neuropathy which may indicate a medical condition is the cause of the pain. 

Imaging tests that may be indicated to help diagnose the cause of heel pain include: 

QUESTION

All ___________ have flat feet. See Answer

What Is the Treatment for Heel Pain?

Treatment to get rid of the pain in your heel depends on the cause. 

Plantar fasciitis treatment includes: 

  • Rest, limited activity, ice, and gentle stretching of the plantar fascia 
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain
  • Protective footwear
  • Shoe inserts
  • Tape support 
  • Steroid injections for pain, though the effects usually only last a few weeks
  • Walking cast 
  • Shockwave therapy 
  • Surgery for plantar fasciitis (a last resort)

Tarsal tunnel syndrome treatment includes: 

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Shoe modification
  • Orthotics
  • Corticosteroid injection 
  • Decompression of the tibial nerve at the ankle 

Achilles tendon insertion and Haglund deformity treatment includes:

  • Concentric or eccentric exercises for Achilles problems
  • Icing
  • Heel lifts
  • Compressive straps
  • Sports insoles and orthotics
  • Topical nitroglycerin 
  • Topical and oral nonsteroidal anti-inflammatory drugs (NSAID) 
  • Extracorporal shock wave lithotripsy
  • Surgery: tendoscopy, open and percutaneous tenotomy, tendon debridement and reattachment, and resection of Haglund deformity with repositioning of the tendon 

Piezogenic papules treatment includes:

  • Restricting weight-bearing exercise
  • Weight loss
  • Compression stockings
  • Foam rubber foot pads or foam-fitting plastic heel cups
  • Corticosteroid injections 
  • Surgical excision (rarely needed)

Subtalar arthritis treatment includes:

  • Limiting standing and walking, particularly on uneven terrain
  • Ice and elevation after activity 
  • Weight loss    
  • Comfort shoes    
  • Ankle brace    
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (Tylenol)
  • Corticosteroid injections
  • Hyaluronic Acid Injections 
  • Strengthening and stretching 
  • Surgery

Flexor hallucis tendinopathy treatment includes:

  • Rest
  • Soft tissue and joint mobilization
  • Shoe implants (e.g., orthotics)
  • Surgical release of the flexor hallucis tendon 

Acute Achilles tendinopathy treatment includes:

  • Avoid aggravating activities
  • Ice
  • Short course of nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Support the Achilles with a heel lift, elastic bandage, or taping

Heel contusion (also called heel pad or foot pad contusion) treatment includes:

  • Rest
  • Ice
  • Support (including a heel pad and possibly taping)
  • Cushioned orthotic
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (Tylenol)
  • Donut-shaped pad at the heel 
  • A period of non-weight bearing if pain is severe

Calcaneal and talar stress fractures treatment includes:

  • Activity restriction 
  • Heel inserts 
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (Tylenol)
  • Crutches and non-weight bearing (for severe pain)

If medical conditions such as arthritis, Paget’s disease, osteomyelitis of calcaneus, sickle cell disease, gout, or metastatic cancer cause heel pain, treating the underlying condition may help resolve the pain. 

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Reviewed on 11/5/2020
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