Heel pain is a common complaint in patients of all ages. There are many factors that can cause heel pain including injury, foot type, tight tissues, shoe gear and growing pains. In this post, i will explore some common causes in different groups and how they can be treated.
Children: Heel pain is common in children from the ages of 10-16. This is often caused by an inflammation in the growth plate which manifests as a sharp pain while running or dull, aching pain after activity. As children grow and begin to play sports, they place more stress across this growth plate which can result in them not wanting to continue to play, or having limitations while they play. If your child is having heel pain, we recommend x-rays to check the growth plate and a physical exam. The diagnosis is called Sever's apophosytis and may be treated with taping the foot, shoe inserts, stretching, icing and anti-inflammatories.
Runners/Athletes: Heel pain in the athletic population has a variety of causes. The most frequently seen pain is plantar fasciitis, an inflammation in the tissue that helps to support the arch. This term is used interchangeably with "heel spurs", although you do not have to have a heel spur to develop fasciitis. This manifests with pain first step after sitting which gradually lessens as the patient walks. Pain returns after standing or walking and can become a sharp/stabbing pain in the bottom of the heel. Plantar fasciitis can be caused by improper shoe gear, overuse, direct injury, foot type or tight achilles tendons. Plantar fasciitis can be diagnosed by exam, x-rays and history of pain. There are several treatments including stretching, icing, anti-inflammatories, shoe inserts, physical therapy and steroid injections. Recently platelet rich plasma (PRP) and amniotic injections have been utilized to help to repair the tissue and get athletes back to activity faster. In extreme cases surgery may be required if conservative care fails.
Not all heel pain is athletes is plantar fasciitis. Achilles tendinitis can occur at the back of the heel and other tendinitis can occur at the sides of the heel. Stress fractures may also occur in the athletic population and need to be ruled out by xray.
General Population: You don't have to be an athlete or a runner to develop heel pain. Plantar fasciitis, achilles tendinitis, other tendinitis and stress fractures can occur in anyone for a variety of reasons. Improper shoe gear, worn shoe gear, over pronation, high arches, flat feet, loss of plantar fat pad, occupation and acitivty can cause fasciitis. We see patients who stand for a living (retails, severs, pharmacists, nurses, law enforcement, etc.) develop fasciitis at a higher rate.
If you are having heel pain, explore our website for other common causes, conditions and treatments. We have a high success rate in the treatment of heel pain when other treatments have failed. Give AZ Choice Foot and Ankle a call and we would be glad to see you for an evaluation and expert treatment.
Chris Suykerbuyk, DPM FACFAS