There are many ways to prevent and resolve heel pain. The solutions don’t have to be medical in nature.
Causes of Heel Pain
Pain in the heel impacts the bottom of the foot and back of the heel. The most common cause of pain on the bottom of the heel is plantar fasciitis. The back of the heel pain is likely due to Achilles tendinitis. Heel pain can cause problems with daily activities, such as walking and exercise. There are many other causes of heel pain, including arthritis, neuropathy, fractures, tarsal tunnel syndrome, gout, bursitis, heel spurs, osteomyelitis, and more.1 Heel pain can occur easily: “Every mile you walk puts 60 tons of stress on each foot”. Exercising or walking on hard surfaces can irritate the heel. Continuing with stressful activities when the heel is already injured can lead to more problems. One type of injury under the heel is a “stone bruise”, due to stepping on a hard object. The fat pad of the heel becomes bruised in this situation. Wearing shoes that rub the back of the heel, or running too much, can trigger back of the heel pain, such as Achilles tendinitis. A heel spur is a calcium deposit, caused when plantar fasciitis is not resolved. Plantar fasciitis can occur when running and jumping lead to inflammation of the fascia (tissue band) that connects the heel to the toes.2 Wearing worn-out shoes and flip flops, which don’t provide arch support, can also be a cause of plantar fasciitis.3 Twisting the foot, or overpronation, can also stress the fascia.4
If there is fever accompanying the heel pain, along with numbness or tingling, it is important to seek treatment. Other reasons to get medical care would be if the heel pain comes after an injury and is severe, if the foot cannot bend down, if the patient is unable to walk normally or stand on their toes, or if there is swelling near the heel. Typical home treatment would begin with RICE (rest, ice, compression, andelevation). Heel pain can also be resolved by properly fitted and supportive shoes. Foot supports or orthotics would also be helpful. Heel cups and wedges can be found over-the-counter, or it may be worthwhile to invest in custom orthotics (i.e., Foot Levelers). It is not uncommon for people to use pain medications, such as ibuprofen or aspirin, to relieve the pain and reduce inflammation.5 Plantar fasciitis and heel spurs can be relieved by special stretching exercises and shoe inserts (such as heel pads). Achilles tendinitis may also require a heel insert, as well as special stretches, NSAID (nonsteroidal anti-inflammatory) medication, and icing.6 Orthotic insoles can help support the arch, resolving causes of heel pain. Besides stretching, patients may also be told to not walk barefoot (and to avoid flip flops). They should wear supportive footwear all day long and change worn-out shoes. Some doctors will use shock wave therapy, an ultrasound beam that can reduce inflammation, or even low-level lasers. Surgery is rarely necessary.7
Masking the heel pain with medication, such as NSAIDS or corticosteroids, is only a short-term fix to the problem. Chiropractors can provide very successful treatment options for heel pain. Plantar fasciitis may respond well to soft tissue manipulation and home exercises.8 Chiropractic care can also offer a stretching regimen. The chiropractor may recommend custom orthotics as well. Night splints may also be required, to help protect the patient from flexing their ankles during sleep.9
Find out how orthotics can help.