Why Do My Heels Hurt? [Causes, Symptoms & Best Treatment!]
Why Do My Heels Hurt? There are 3 major causes of heel pain. The most common is inflammation of the foot ligaments. But this is very treatable!
Table of Contents
Heel Pain Causes: Picture & Photo Gallery
Look:
- One of the top causes of heel pain is plantar fasciitis. This is damage to a ligament that holds your heel to your toes.
- Another root cause of heel pain has flat feet.
- There are also photos of heel spurs that can occur to the bottom of your heel (plantar fascia insertion) and the back of your heel (Achilles tendon insertion).
- Baxter’s nerve entrapment can also happen at the bottom of the heel.
- An underlying cause is an overpronated flatfoot or an over a supinated high arched foot.
- A plantar fibroma is a thick nodule that can occur within your plantar fascia ligament and contribute to plantar fasciitis.
- This can lead to the formation of a heel stress fracture( AKA calcaneus stress fracture.)
Please click on the gallery for a guided tour through heel pain conditions!
6 Common Causes of Heel Pain:
1) Plantar fasciitis is the most common one:
- It is said that 10-40% of people in the world will have chronic heel pain.
- 93% of that is said to be plantar fasciitis.
- This is the most common cause of heel pain in the world.
- It is said that 44% of all foot clinic visits are related to a combination of plantar fasciitis.
- If you have a bottom of the foot and heel pain during the morning, this is likely plantar fasciitis!
- This usually gets better after 10-20 morning steps but then hurts the next morning.
2) Achilles Tendinitis & Back of the Heel Pain:
- This is the most common cause of pain in the back of the heel. It is possible to develop heel spur and rest soreness at the site of the Achilles tendon inserts.
- It is also possible to have it about 2 to 6 cm above the heel bone (Called the middle of the Achilles tendon pain).
- It is also possible to strain the actual calf muscle, but it is not Achilles tendinitis, not heel pain.
- This is perhaps the most important ended in the body in terms of bearing weight.
- Common in older people common and those who have had steroid injections, it is thought that he can start at 40, but it does continue later in life.
- We see this most commonly in much older people such as the 60s, 70s, 80s, and higher.
- If you are younger, it is doubtful that this is your problem.
- This is usually achy, burning pain that gets worse during the day.
- This is a widespread condition that we see overall, and it does need to be treated effectively!
- This is increased pain while you are bearing weight.
- These are typical during running sports and repetitive shocked heels.
- It is tested by checking side to side squeeze of the heel bone.
- The calcaneal squeeze test is critical in confirming that heel stress fracture.
- Click on the above link to make sure this is not your problem!
5) Radiculopathy (Back Pain):
- If you have ever had a back injury or nerve injury to your spine, you may have radiculopathy pain.
- This can cause numbness, burning, and tingling-type pain.
- We see this very commonly in people who have soreness and pain in both feet.
- If you have a prior back injury or surgery, this may be your problem.
- Baxter’s nerve compression and entrapment is not the most common cause of heel nerve pain.
- Some sources even say Baxter’s nerve compression can be involved in up to 20% of heel pain cases!
- This can result in more nighttime pain, as well as pain during rest.
- If you have numbness, burning, and tingling, it may be Baxter’s pinched nerve in the heel!
Heel Pain Causes:
Diagnosis requires asking a couple questions:
Question #1) Do Your Heels Hurt In The Morning?
- If No: Jump to Question #2.
- If Yes: Continue reading.
If you do have morning foot pain consider:
Pain that is worst after resting, sitting or sleeping is always due to inflammation:
- Inflammation is your body trying to remodel itself or protect itself.
- It is triggered due to overuse or too much stress on your muscles in this case.
- The ligaments on your foot can become tight & painful after a full day off walking.
- Then as you rest or go to bed, your body tries to remodel them.
- This pain usually takes years to get to the point where it causes severe pain.
- It can even cause a heel spur to form on your foot!
How Common Is Plantar Fascia Heel Pain?
- This is the most common source of heel pain in the world.
- 15% of people around the world suffer from this medical problem.
- That means almost 1 billion people in the world will have this.
- This pain is due to inability to heal the strained ligaments across the bottom of the foot.
Symptoms of Plantar Fasciitis:
- Heel pain after resting .
- Heel pain after sitting.
- Heel pain after sleeping.
- Pain gets better after walking around for 15-20 minutes.
- No history of severe trauma.
- Pain gets better with anti-inflammatory medication or icing.
- Massaging the arches makes the pain feel better.
Question #2: Do You Have A Lump Or Bump On The Heel?
- If No: Jump to Question #4.
- If Yes: Continue reading.
- A plantar fibroma is a relatively non-dangerous condition; but it can become extremely painful.
- It feels like a “pebble” or hard nodule of connective tissue in your sole.
- It could even feel like a much larger thickening of the cords at the bottom of your foot.
- It could be one nodule or many.
How Did This Foot Or Heel Lump Develop?
- These nodules are extremely slow growing.
- It could take months to years before they even begin to irritate you.
- They eventually lead to more and more irritation.
- Eventually causing your toes to bend and stiffen because you adapt your biomechanics and walk improperly.
- Eventually this irritation becomes to much to bear and your heel hurts.
Question #3: Is It The Back Of The Heel That Hurts?
- If No: Jump to Question #4.
- If Yes: Continue reading.
Consider Pain In The Back Of The Heel:
This can be due to:
- This is likely the most common source of pain in the back of the heel.
- It is not at the bottom but the back.
- This can be a hard bone bump at the back of the heel.
- This is usually on the inside of the heel.
- It can cause numbness, burning or tingling.
D) Posterior Tibial Nerve Entrapment.
- This is usually on the inside of the heel.
- It can cause numbness, burning or tingling.
Question #4: Does The Outside Of My Heels Hurt?
- If No: Jump to Question #5.
- If Yes: Continue reading.
Possibilities:
Question #5: Do My Heels Hurt After Run Training.
Consider:
Best Heel Pain Products:
- There are usually two phases to treating plantar fasciitis pain.
- The two phases of treatment include controlling the acute inflammation, and correcting the biomechanics which led to the problem in the first place.
- If the tendons and ligaments are inflamed, they are almost frozen in place and cannot function properly.
- Once the inflammation is decreased, we need to correct the bio-mechanical causes to ensure that they can never become over worked and inflamed again!
- This doesn’t matter whether it’s plantar fasciitis, plantar fibroma, sore bottom of foot, or even Achilles tendon pain. Treatment is all roughly very similar.
Plantar Fasciitis or Achilles Tendonitis Inflammation:
Massage & Ice Products:
- Ice is the an excellent option that can be safe for almost everyone.
- There is some debate whether icing is worth doing, but for chronic pain this can help limit the need for medications and keep your options open.
- This works great for your arch, less for the ball of the foot.
- The more muscle and ligament tissue there is, the better ice will work there.
Menthol Based Gels:
- Biofreeze is one of our favorites.
- These gels have been studied to work 2x as long as ice.
- This works great for the ball of the foot.
- This can be very effective for bottom of the heel and Achilles tendon sore regions.
Massage Sticks:
- These can work great for loosening your muscles.
- This allows less tightness and pressure on the ball of your foot.
- This is very effective for the arch, the gastrocnemius or calf muscle and for the hamstring and thigh muscles.
- This also works very well for the gluteus muscles if you are having butt cheek or hip pain.
Remove the Plantar Fascia or Achilles Tendon Stress:
- The key is to prevent future pain.
- This means keeping you active while keeping stress off of your plantar fascia tendon. This will prevent future re-injury and development of plantar fasciitis.
- If you can get rid of the pain and swelling, this will let you start walking normally.
- If you can walk normally, the vast majority of your pain should gradually start to go away.
- The best way to ensure that your plantar fascia, foot and ankle ligaments are not overworked is to support them.
- The best way to support them is to use great orthotics and great shoes.
- Some people may also need to rely on supportive ankle braces and other supportive modalities.
The Best Heel Pain & Plantar Fasciitis Shoes:
- Getting a great supportive pair of shoes will make sure that there is pressure removed from the heel and plantar fascia region.
- This is especially important if you have plantar fasciitis, heel spur pain or Achilles tendonitis.
- Consider shoes combined with a good supportive orthotic for best pain relief!
- The following link will show you what our favorites are.
Best Heel Pain & Plantar Fasciitis Orthotics:
- These are our recommended orthotics for plantar fasciitis.
- Custom orthotics can work very well, but they should not be a first line of treatment.
- There are different types for different shoes.
- Women’s shoes usually need a less bulky orthotic, but allow for less correction.
- A full length orthotic requires a running shoe, boot or comfortable walking/dress shoe.
- We recommend doing everything you can to get a good supportive shoe that can fit a full length orthotic.
- This is the best way to maximize your orthotics for great results.
Best Full Length Orthotics:
- These will only work in wider shoes or a good supportive running shoe.
- This will not work in sandals, flats or most women’s dress shoes.
Best Dress Shoe Orthotics:
- These are a great choice for dress orthotics.
Best 3/4 Length Orthotics:
- These are great options for women’s dress shoes and thinner shoes.
- These are not the most supportive pair of orthotics.
Get A Great Dynamic Stretch:
- It is possible to stretch on your own, but these products can also really help!
- This will take pressure off of the ball of your foot.
- We personally prefer this method of stretching.
Get A Great Static Stretch:
- These devices are great for stretching while you are resting.
- This will also help take pressure off of the ball of your foot.
- This works great for plantar fasciitis.
- It can be used while watching TV or at night time.
Best Heel Compression Brace:
- A good compression brace can stabilize your foot from turning outward.
- This prevents your foot from pronated.
- Pronated foot will turn your foot outward in your foot will rub on the outside of the shoe.
- For many of her patients this has solved their pain and is very comfortable to wear inside your shoe.
- This solves both pain and outward pronation for a relatively low cost.
Best Heel Stability Brace:
- Stability brace goes little bit further than the compression brace to stop your foot from turning out.
- This takes pressure off of your heel and plantar fascia.
- At the same time this is a little bit bulkier and does not affect every shoe.
- We find people are little bit happier trying the compression brace before the stability brace.
Heel Injury:
- If you think you might have a broken heel, a calcaneal stress fracture or something of similar severity, these products might help!
- Always remember to see a foot and ankle specialist like a podiatrist if you are having plantar fasciitis or more severe pain!
Plantar Fascia Tear, Broken Heel Bone, Achilles Tendon Tear:
- If you have a traumatic injury such as a torn plantar fascia ligament, calcaneus stress fracture, heel fracture or insertional Achilles tendon injury: consider protecting your foot!
- The best way to do this is of course to see your podiatrist and get evaluated with an x-ray, ultrasound and potentially even an MRI or CT scan.
- If you are unable to do so it may benefit you to be in a cast, fractured boot, or even keep the weight off of it with a rolling knee scooter or other protective devices.
- We as podiatrists frequently take patients off work for very long period of time when they suffer a traumatic injury, unfortunately there is no other way around us in labor jobs.
- If you have a sit down job there are ways to get people back to work quicker, but this can be very difficult otherwise.
Heel Injury Boot Treatment:
- There are pros and cons to using a boot to treat your heel injury. If you are immobilized too long the cons are that you will gradually become stiff and overworked to your other leg. The Pros are that you injured heel will hopefully have a chance to gradually heal!
- Our favorite fracture boots and their supplies:
Offloading and Scooter treatment:
- These are favorite knee scooters and walking devices: