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Relief for Painful, Inflamed Heels
| Sharp pain, aching or stiffness on the bottom of
one of both heels is a very common ailment. The
pain is often at its worst upon awakening in the
morning (or after sitting down for an extended
period and the resuming activity), causing
hobbling or limping for few minutes before a
comfortable stride can be resumed. As weight
continues to be applied during walking or
standing, mild or severe pain may persist.
Causes of Heel Pain
| Heel pain originates deep
within the foot, directly on
the heel bone or within the
foot's connective tissues,
called the fascia. Several layers of fatty
tissue surround the heel
bone, softening the impact
or walking and running
and protecting the bones
and muscles of the foot.
Beneath this padding, a
tissue (the fascia) extends
from the heel bone, supports
the arch and
reaches across to the
toes. Pain can result
when these tissues
become irritated or
inflamed, or when small
spurs grow on the heel
bone.
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Inflammation
Most cases of heel pain are characterized by
Inflammation. First, the fascia begin to pull on
The bone and the tissues becomes irritated, then
Inflamed. Inflammation of the fascia is called fascitis.
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Heel Spurs
A projection or growth of bone may be called a
spur, and can grow where the muscles of the foot
attach to bone. While some heel spurs are
painless, others that are determined to be the
cause of chronic heel pain may require medical
treatment or surgical removal (see "Surgical
Treatments for Heel Pain").
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Other Causes
While injury, overuse or other temporary,
mechanical causes can bring on discomfort in the
heel, a painful heel may also accompany a more
serious condition, such as:
 | Gout
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| Arthritis
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| Psoriasis
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| Collagen disorders
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| Nerve injuries
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| Heel bone abnormalities
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| Tumors
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Illnesses like these and others must be diagnosed
and treated separately. Your podiatric surgeon
may refer you to a local specialist if the problems
are beyond his or her area of expertise.
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Caring for the Painful Heel
In most cases, heel pain can be relieved without
surgery. Treatment may include self-care,
medications, therapy or orthotics.
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Self-Care
Several steps can be taken to care for a painful
heel at home.
| Take medications that contain ibuprofen
or aspirin daily as directed, for as long as
symptoms persist, to help reduce tissue
inflammation.
Follow dosage directions carefully.
As with any medication, be aware of
potential allergic responses and
discontinue use if any adverse
reaction occurs, or if pain is not
relieved after several days' use.
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| Soak the heel in ice water to
relieve pain and inflammation. This
works best by placing the foot
In a basin filled with tap water,
high enough to cover the heel. Allow
the foot to adjust to this temperature.
Then add ice cubes (two or three
at a time) every five or six minutes
over a 30-minute period. Soak the
foot in ice water three times
daily and immediately after any
activity. Heat may also be
recommended, but ice is usually
preferable. Caution: People with diabetes or
poor circulation should not use cold
water or ice packs.
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| Avoid sports and other vigorous
Activities while heeling.
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| Wear higher heeled shoes and
choose shoes with heels made
from soft rubber instead of leather.
Running shoes are often the most
comfortable.
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| Stretch the calf muscles daily.
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Nonsurgical Medical Treatment
If self-care measures do not relieve the pain, the
podiatric surgeon may recommend various treat-
ments to reduce inflammation. Some of these may
include:
| Prescription oral nonsteroidal
anti-inflammatory medications to
reduce both pain and inflammation.
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| Cortisone injections
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| Foot taping and padding
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| Physical therapy - The podiatrist or
physical therapist may treat heel
pain with ultrasound, electrical
stimulation or hydrotherapy. Each
of these methods may help reduce
inflammation.
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| Custom orthotics - A foam or plastic
orthotic (custom-made to fit the foot)
can often relieve the strain on the
tissues and permit the heel to recover.
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Surgical Treatments for Heel Pain
If nonsurgical medical treatments fail and pain
persists, surgical intervention may be necessary.
Both surgical procedures described below are
usually completed on an outpatient basis in less
than one hour. They are performed comfortably
under either local anesthesia or minimal sedation
administered by trained personnel.
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