Pain in the Heel: Causes and Treatment Options

Pain in the soles of the feet?

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?

Meizi, 10~19 year old female. Ask Date: 2005/08/26

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 typically worsen in the morning upon waking, after long-distance walking, or when climbing stairs.

In terms of physical therapy management principles:
1.
Pain management: Use modalities such as transcutaneous electrical nerve stimulation (TENS) or thermotherapy (heat packs, hydrotherapy, ultrasound) to alleviate pain and relax the fascia;
2.
For exercise therapy, it is recommended to perform calf stretching exercises, specifically in a lunge position with the stretching leg behind, heel on the ground, knee straight, and weight shifted to the front leg with the front knee bent until a stretch is felt in the calf of the back leg, holding for 10-20 seconds, and performing at least 10 repetitions;
3.
Medication can effectively reduce pain;
4.
When selecting footwear, avoid hard-soled and high-heeled shoes.
If the plantar pain is severe, it is advisable to seek treatment at a hospital.

Our medical team is happy to provide you with professional consultation and services.
Wishing you health and safety.

Best regards,
Hsu Chen-Jung
Department of Rehabilitation, Taipei Hospital

Reply Date: 2005/08/26

More Info

Heel pain can be a frustrating and debilitating condition that affects many individuals. Understanding the underlying causes and treatment options is essential for effective management. Based on your description of sudden pain in the heel area, particularly when standing, there are several potential causes to consider.

Common Causes of Heel Pain
1. Plantar Fasciitis: This is one of the most common causes of heel pain, particularly in individuals who are active or overweight. The plantar fascia is a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes. Overuse, improper footwear, or excessive weight can lead to inflammation of this tissue, resulting in pain, especially with the first steps in the morning or after prolonged sitting.

2. Achilles Tendinitis: This condition involves inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. It can cause pain at the back of the heel and is often exacerbated by activities that involve running or jumping.

3. Heel Spurs: These are bony growths that develop on the underside of the heel bone, often associated with plantar fasciitis. While heel spurs themselves may not cause pain, they can be a sign of underlying inflammation.

4. Bursitis: Inflammation of the bursa, a small fluid-filled sac that cushions the heel, can lead to pain and discomfort, particularly when standing or walking.

5. Stress Fractures: Repetitive stress or overuse can lead to small cracks in the heel bone, causing localized pain that worsens with activity.

6. Nerve Entrapment: Conditions such as tarsal tunnel syndrome, where the posterior tibial nerve is compressed, can cause pain in the heel and may be accompanied by tingling or numbness.

Treatment Options
1. Rest and Ice: Taking a break from activities that exacerbate the pain and applying ice to the affected area can help reduce inflammation and alleviate discomfort.

2. Footwear: Wearing supportive shoes with adequate cushioning can make a significant difference. Avoiding high heels or shoes with inadequate support is crucial.

3. Orthotics: Custom or over-the-counter orthotic inserts can provide additional arch support and help distribute pressure more evenly across the foot.

4. Stretching and Strengthening Exercises: Engaging in exercises that stretch the calf muscles and plantar fascia can improve flexibility and reduce tension. Strengthening exercises for the foot and ankle can also be beneficial.

5. Physical Therapy: A physical therapist can develop a tailored exercise program to address specific issues contributing to heel pain.

6. Medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help manage pain and inflammation.

7. Injections: In some cases, corticosteroid injections may be recommended to reduce inflammation, particularly if conservative measures are ineffective.

8. Surgery: If conservative treatments fail and pain persists, surgical options may be considered, particularly for conditions like plantar fasciitis or heel spurs.

When to Seek Medical Attention
If your heel pain persists despite home treatment, worsens, or is accompanied by other concerning symptoms (such as swelling, redness, or inability to bear weight), it is essential to consult a healthcare professional. They may recommend imaging studies, such as X-rays or MRI, to determine the underlying cause of your pain and develop an appropriate treatment plan.

In summary, heel pain can arise from various causes, and understanding these can help guide effective treatment. Early intervention and appropriate management strategies are key to alleviating pain and restoring function.

Similar Q&A

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 Persistent Heel Pain: Causes and Treatment Options

Dear Dr. Chang, My boyfriend suddenly experienced heel pain three weeks ago. He has been diagnosed with gout since last year, so we initially thought this pain might be related to that. We started adjusting his diet, but after about a week, there was no improvement. The pain shi...

Dr. Zhang Qiongwen reply Rehabilitation
You can visit the rehabilitation department for an evaluation and treatment to determine whether it is caused by gout or a tendon injury. A detailed assessment of the patient will be necessary to make a definitive diagnosis.

Understanding Heel Pain: Causes, Symptoms, and Treatment Options

Doctor, my foot pain occasionally radiates to my toes and the sole of my foot. The pain points are located at the heel and the bony prominence on the inner side of the foot near the heel. Both of these areas are extremely painful when pressed lightly. My big toe trembles uncontro...

Dr. Shi Guozheng reply Orthopedics
Typically, conservative treatment methods such as medication, local steroid injections, or shockwave therapy can be used to treat conditions that do not require surgery.