is one of the most common conditions treated by podiatrists. It is often a message from the body
that something is in need of medical attention. Pain that occurs right after an injury or early in an illness may play a protective role, often warning us about the damage we have suffered. The
greatest incidence of heel pain is seen in middle-aged men and women. It is also seen in those who take part in regular sporting activities and those significantly overweight and on their feet a lot.
Heel pain can also occur in children, usually between 8 and 13, as they become increasingly active in sporting activities.
If you have pain behind your heel, you may have inflamed the area where the Achilles tendon inserts into the heel bone (retrocalcaneal bursitis). People often get this by running too much or wearing
shoes that rub or cut into the back of the heel. Pain behind the heel may build slowly over time, causing the skin to thicken, become red and swell. You might develop a bump on the back of your heel
that feels tender and warm to the touch. The pain might flare up when you first start an activity after resting. It often hurts too much to wear normal shoes. You may need an X-ray to see if you also
have a bone spur.
The symptoms of plantar fasciitis include pain along the inside edge of the heel near the arch of the foot. The pain is worse when weight is placed on the foot especially after a long period of rest
or inactivity. This is usually most pronounced in the morning when the foot is first placed on the floor. This symptom called first-step pain is typical of plantar fasciitis. Prolonged standing can
also increase the painful symptoms. It may feel better after activity but most patients report increased pain by the end of the day. Pressing on this part of the heel causes tenderness. Pulling the
toes back toward the face can be very painful.
In most cases, your GP or a podiatrist (a specialist in foot problems and foot care) should be able to diagnose the cause of your heel pain by asking about your symptoms and medical history,
examining your heel and foot.
Non Surgical Treatment
Initially, treatment will consist of adding support to the foot, including better shoes and an over-the-counter arch supports and/or insoles; resting from the sport or activity that aggravates the
problem; stretching the calf and arch muscles; taking anti-inflammatory; and using ice and massage to reduce inflammation. You can ice and message your muscles simultaneously by freezing a water
bottle filled with water and using it to massage your foot by rolling it underneath your foot for five to 10 minutes at least two times per day. It is not unusual for symptoms of plantar fasciitis to
persist for six to 12 months despite treatment.
Only a relatively few cases of heel pain require surgery. If required, surgery is usually for the removal of a spur, but also may involve release of the plantar fascia, removal of a bursa, or a
removal of a neuroma or other soft-tissue growth.
You can help to prevent heel pain by maintaining a healthy weight, by warming up before participating in sports and by wearing shoes that support the arch of the foot and cushion the heel. If you are
prone to plantar fasciitis, exercises that stretch the Achilles tendon (heel cord) and plantar fascia may help to prevent the area from being injured again. You also can massage the soles of your
feet with ice after stressful athletic activities. Sometimes, the only interventions needed are a brief period of rest and new walking or running shoes.