Heel Pain: Causes, Treatments, and Rehabilitation Options

Foot problems (heel pain)

Two days ago, I went hiking at Kenting Shodong Park.
Since it was difficult to walk in sandals, I took them off and walked barefoot.
Not long after, I stepped on a protrusion on the stone steps, which caused a sharp pain.
I stayed still until the pain subsided before continuing to walk.
During the walk, I occasionally stepped on the same spot, but eventually, the pain disappeared.
However, this morning when I woke up, I started to feel pain and a tingling sensation in my heel.
I'm unsure if this is plantar fasciitis, a tendon rupture, or a tendon tear.
I wonder if ultrasound therapy combined with massage would be effective.
I have previously experienced plantar fasciitis located on the medial arch of my foot.
Although I have received treatment including massage, ultrasound, and electrical therapy, it sometimes recurs.
I'm uncertain how to achieve a complete cure.
Additionally, the fourth bone (cuboid bone) in my right foot's little toe protrudes more than the left foot, and sometimes the joint area is painful.
I'm not sure if this is related to an ankle sprain I had in elementary school or if it is due to overuse and misalignment of the bone, or if it involves the plantar fascia or tendon rupture.
I am unsure which specialty to consult—traditional Chinese medicine, folk therapy (massage), or rehabilitation.
I hope to find a solution without taking medication!

Cai Tongxue, 10~19 year old female. Ask Date: 2016/05/31

Dr. Yin Xinbei reply Rehabilitation

Based on the injury history, it is likely plantar fasciitis or inflammation of the fat pad in the heel.
It is recommended to consult a rehabilitation specialist, as improper manipulation may worsen the inflammation.

Reply Date: 2016/05/31

More Info

Heel pain can be a common issue, especially after an incident like stepping on an uneven surface, as you described. The pain you are experiencing could be attributed to several potential causes, including plantar fasciitis, tendon injuries, or even structural issues with the bones in your foot.

Understanding the Causes
1. Plantar Fasciitis: This is one of the most common causes of heel pain. It occurs when the plantar fascia, a thick band of tissue that runs across the bottom of your foot, becomes inflamed. Symptoms typically include sharp pain in the heel, especially with the first steps in the morning or after sitting for a long period.

2. Tendon Injuries: The Achilles tendon, which connects the calf muscles to the heel bone, can become strained or torn, leading to pain in the heel area. This can happen due to sudden increases in activity or improper footwear.

3. Bone Spurs: Sometimes, calcium deposits can form on the heel bone, leading to a condition known as a bone spur. This can cause pain, especially when pressure is applied.

4. Structural Issues: As you mentioned, the protrusion of the fourth metatarsal bone in your right foot could indicate a structural issue. This might be due to a previous injury or overuse, leading to misalignment or excessive pressure on certain areas of the foot.

Treatment Options
Given your preference for non-pharmacological treatments, here are some options you might consider:
1. Physical Therapy: Engaging in a rehabilitation program with a physical therapist can be beneficial. They can provide exercises to strengthen the muscles in your foot and improve flexibility, which can alleviate pain and prevent future injuries.

2. Ultrasound Therapy: This treatment uses sound waves to promote healing in soft tissues. It can be effective for conditions like plantar fasciitis and tendon injuries.

3. Manual Therapy: Techniques such as massage or manipulation can help relieve tension in the muscles and fascia around the heel, improving blood flow and reducing pain.

4. Orthotics: Custom or over-the-counter orthotic inserts can help correct structural issues in your foot, providing better support and alignment, which can alleviate pain.

5. Rest and Ice: Allowing your foot to rest and applying ice can help reduce inflammation and pain, especially after activities that exacerbate your symptoms.

6. Stretching Exercises: Regular stretching of the calf muscles and plantar fascia can help relieve tension and improve flexibility, which may reduce heel pain.

When to Seek Medical Attention
If your pain persists despite these treatments, or if you experience severe pain, swelling, or difficulty walking, it would be wise to consult a healthcare professional. A podiatrist or orthopedic specialist can provide a thorough evaluation, including imaging studies if necessary, to determine the exact cause of your pain and recommend appropriate interventions.

Conclusion
Heel pain can stem from various causes, and understanding the underlying issue is crucial for effective treatment. Since you have a history of plantar fasciitis and potential structural concerns, a combination of physical therapy, ultrasound, and manual therapy may be beneficial. Always listen to your body and seek professional advice if symptoms do not improve. Remember, early intervention can often prevent more serious complications down the line.

Similar Q&A

Understanding Pain in the Heel: Causes and Treatment Options

Last night, I suddenly noticed that the back half of the sole of my right foot hurts when I stand. What could be the cause of this?

Dr. Xu Zhenrong reply Rehabilitation
Hello, Your symptoms appear to be consistent with plantar fasciitis, which is inflammation of the plantar fascia caused by repetitive strain. The main symptoms include: 1. Intermittent pain on the inner side of the heel, especially during weight-bearing activities; 2. Symptoms ...

Understanding Heel Pain: Causes, Diagnosis, and Treatment Options

Hello Dr. Hsu, I injured my ankle while playing basketball around the end of July last year. After not fully recovering, I played again and landed awkwardly, putting all my weight on my heel. At that moment, I felt a sudden sharp pain in my right heel. I didn't think much o...

Dr. Xu Zhaoren reply Orthopedics
Based on the symptoms you described, it is likely "plantar fasciitis." The causes can be varied, including chronic or acute strains and other forms of arthritis. Treatment methods include rest, wearing ergonomically designed shoes, and appropriate physical therapy. Impr...

Heel Pain: Understanding Tendonitis and Treatment Options

Three months ago, I suddenly experienced pain in the bottom of my right heel. It hurts more when I first get up in the morning or after sitting for a long time. The hospital diagnosed it as tendonitis after an X-ray. I have undergone intensive ultrasound and electrical therapy, t...

Dr. Shi Qiming reply Orthopedics
Based on your symptoms, the diagnosis of tendonitis is accurate. The causes may include prolonged standing or walking beyond your physical capacity, or excessive weight bearing (lifting heavy objects). Ultrasound and electrical therapy are among the treatment methods, but it is e...

Understanding Heel Pain: When to Seek Rehabilitation Treatment

When I walk for a longer duration, I experience pain on the right side of my heel. It also hurts when I press down on it. I previously consulted a traditional Chinese medicine practitioner who performed bloodletting, but it did not improve. Recently, I have also started to feel p...

Dr. Chen Xianchang reply Rehabilitation
Hello, thank you for your inquiry. Here are my responses and recommendations: 1. Generally speaking, pain on the right side of the right heel may be attributed to two possibilities: one is inflammation of the Achilles tendon, and the other is inflammation of the ligaments betwe...