What causes your heels to hurt .pdf
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What causes your heels to hurt?
By-Dr. Clifford Wolf
Trust e, ou are ’t the o l o e! It is o e of the
most common problems I see. The best way to
combat this problem is to attack it with full
force...as soon as possible.
Heel pain can have many different causes. The
patients that generally suffer most from this
condition are the ones on their feet a lot.
Continuous standing; walking on a daily basis;
starting a repetitive activity, such as a new
exercise routine, without proper shoes, can put a
lot of stress and strain on the ligaments in the
foot. It eventually results in inflammation and
The good news is, heel pain is treatable. If
treatment is sought early, all but a small
percentage of affected patients will experience
relief with conservative therapies. These include:
limiting activities, footwear modifications, and
stretching exercises. Procrastination can cause
the pain to become not only chronic, but
debilitating as well.
Major causes of heel pain and their treatment.
While there can be many reasons for heel pain,
generally it is categorized into four major causes:
plantar fasciitis, Achilles tendonitis, bursitis and
nerve pain. Diagnosing the specific issue depends
on the exact location of the pain and how the
pain affects the mechanical movement of the leg.
Plantar fasciitis — This is the most common cause
of heel pai . It’s a i fla
atio of the a d of
tissue (the plantar fascia), that extends from the
heel, to the metatarsal heads.
When patients suffer from this ailment, the fascia
becomes irritated and then inflamed, resulting in
heel pain or pain in the arch of the foot. Plantar
fascia pain is a tell-tale sign that there are
mechanical issues going on in how the foot
We typically treat plantar fasciitis first with nonsurgical strategies, such as stretching exercises;
rest; footwear modifications; orthotic devices;
night splints and injection therapy. While most
patients respond well to conservative treatments,
some require surgery to correct the problem.
The injection therapy is something that would
have to be administered by your GP, as it is not
something that falls within my scope of practice.
Achilles tendonitis — Also known as inflammation
of the Achilles tendon, can also be a cause of heel
pai . We ofte see this o eruse o ditio i
athletic patients who play high-impact sports, like
basketball or tennis.
They often have a sudden increase of repetitive activity
involving the Achilles tendon, which puts too much
stress on the tendon too quickly, leading to micro
To treat this condition, you can immobilize the foot
with a walking boot or cast, along with physical therapy
application, orthotics, and ice to help repair the
tendon. If the tendon is severely damaged, or if
o surgi al treat e ts do ’t ork, surger a e
Bursitis — Another cause of heel pain commonly seen, is
here the fat pad of the heel e hi its red ess a d
swelling from inflammation of the small fluid-filled sac
inside the heel, called the bursa. The bursa, which
protects the heel from friction, can become inflamed
from repetitive motion or irritation from shoes.
In the case of bursitis, the heel and the toes are
most often affected. Treatment may include
resting the foot, ice, anti-inflammatory drug
therapy, padding, and corticosteroid injections to
reduce the inflammation and relieve pain.
Surgery may be necessary if conservative
methods do not provide relief.
Nerve pain — Is a somewhat less common cause of
heel pain. When the nerves are involved, it feels
more like a burning or electrical pain, shooting or
radiating down the foot from the heel, typically
towards the toes. A patient will often tell me
their heel ur s. There are edi atio s that
may help with nerve pain, but in this instance,
the patient tends to need nerve decompression
surger , a pro edure to help untrap the er e.
These patients tend to have several misdiagnoses,
before they visit with a specialist to correctly
remedy their pain.
Whatever your heel pain, I always encourage
people to see a podiatrist or orthopaedic surgeon
for a proper diagnosis. We specialise in the lower
limbs, and our training helps us to effectively get
to the bottom of what is ailing our patients.
When conservative therapies do not provide
relief after several months, steroidal injections
are the next step. If still no relief, surgery may be
Your feet mirror your general health . . . cherish
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