Heel pain is a common medical condition affecting many people these days. This ailment holds no wonder considering the amount of impact our heels take daily. One of the primary impact points of our body is our heels. They take the full body weight whenever we are in motion and the forces put on our heels are much higher than the weight of our body!

When pain in the heels strikes, it ranges from a mild twinge to unbearable agony. It is pretty unusual to have pain in both the heels, with the left heel being more prone to get affected easily. However, when one of your heels is affected by pain, the pace of walking is altered and you tend to put more strain on the other heel to compensate or balance your entire body weight.

The exact nature and location of the pain indicates 2 signs of the underlying condition. Medically heel pain is categorized as inferior heel pain or posterior heel pain. Inferior heel pain is a common condition that occurs directly below the heel and posterior heel pain is experienced at the front of the foot. Most of the cases of inferior heel pain are caused by bruising and planter fasciitis.

Luckily, heel pain can be easily treated – all thanks to the large number of effective and reasonable treatment methods available these days.

The general causes of heel pain- at a glance

A. Plantar Fasciitis: This is by far the most common cause of heel pain! The planter fascia is a tough, fibrous broad tendon running from the heel to the ball of the foot. The plantar fascia acts as the arch of your foot that is responsible for shock absorption and cushioning. Inflammation of the plantar fascia is commonly known as tendonitis that causes extreme pain and gets worse after hours of rest or during the first morning hours.

In many people the plantar fascia ligament is affected by permanent excessive strain. When the fascia become overly stretched for long periods of time, the result is micro-tearing of the tissue and eventually inflammation. The literal meaning of Plantar Fasciitis is ‘inflammation of the plantar fascia’.

Overstretching of the plantar fascia ligament may occurs as a result of:

• being overweight
• overuse, e.g. too much sports, running or exercises, standing for long hours at work
• being pregnant
• wearing unsupportive footwear (e.g. shoes without a strong heel counter and/or no support in the arch area, flip-flops, sandals etc)
• biomechanical faults in your gait e.g. excess pronation, fallen arches, flat feet etc

“Pronation” is a natural rolling mechanism of the foot and serves as our natural human shock-absorbing mechanism (like the shock-absorbers in your car).  However, a lot of people tend to over-pronate i.e. their feet excessively roll inwards while running or walking. It is estimated over 70% of the American population suffer from excess pronation. Carrying more than our normal body weight puts excessive forces on our feet and is therefore a major contributing force to excessive pronation.  The ‘cure’ for excess pronation is wearing a strong and supportive orthotic insole.

B. Heel bruise: Hard objects like rocks and stones under the foot can bash the tender tissues while causing intense pain while walking. Such a situation is called stone or heel bruising that occurs due to sudden heavy landing of the foot on some irregular surface or from constant pounding.

C. Heel spurs: It is commonly associated with Plantar Fasciitis. This condition is mostly found in patients suffering from prolonged heel pain due to plantar fasciitis. It is a condition caused from excessive bone growth from the heel bone calcaneus and is approximately present in every 3 of the 4 plantar fasciitis patients.

D. Tarsal Tunnel syndrome: Due to this condition, a large nerve in the rear of the foot gets pinched and strained. It bears heavy resemblance with carpal tunnel syndrome that occurs in the hand. It is yet another cause of intense heel pain.

E. Posterior heel pain: This condition shows its effects behind the foot instead of below the limb. It causes retrocalcaneal bursitis and Achilles tendonitis.

F. Stress fractures: Although it is an uncommon cause that occurs in the calcaneus but is often considered one of the causes of heel pain. Mostly athletes and sportsmen tend to suffer from this condition leading to heel pain.

G. Paget’s disease: It is an again a rare cause of heel pain and is responsible for the irregular remodeling of the bone. it is marked by the formation of abnormal and enlarged growth of bones which are brittle and less dense and are prone to possible breakage. However, this condition shows no symptoms and its cause is also unknown to all but many medical experts assume this condition as a genetically driven ailment further fuelled by viral infections.

Some other possible causes of heel pain include the following:-

• Soft tendons or tissues, infection in the bone
• Gout
• Arthritis
• Diabetes
• Inflammatory arthritis
• Primary as well as secondary malignant and benign tumors