Heel Pain: Causes and When to See a Doctor - Family Medicine

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Heel pain, particularly when it occurs upon waking or after periods of inactivity, can be attributed to several potential causes. The most common condition associated with heel pain is plantar fasciitis, which is characterized by inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of the foot and connects the heel bone to the toes. This condition often presents as sharp pain in the heel, especially with the first steps in the morning or after sitting for long periods.

Another possible cause of heel pain is Achilles tendinitis, which involves inflammation of the Achilles tendon, the band of tissue that connects the calf muscles to the heel bone. This condition can lead to pain at the back of the heel and is often exacerbated by physical activity or prolonged periods of standing.

Other conditions that may lead to heel pain include:
1. Heel Spurs: These are bony growths on the underside of the heel bone that can develop due to chronic inflammation of the plantar fascia. They can cause pain, especially when walking or standing.

2. Bursitis: Inflammation of the bursa, a small fluid-filled sac that acts as a cushion between bones and soft tissues, can lead to heel pain.

3. Tarsal Tunnel Syndrome: This condition occurs when the tibial nerve is compressed as it passes through the tarsal tunnel near the ankle, leading to pain that may radiate to the heel.

4. Stress Fractures: Overuse or repetitive stress can lead to small cracks in the heel bone, resulting in pain that worsens with activity.

5. Systemic Conditions: Conditions such as arthritis or other inflammatory diseases can also contribute to heel pain.

Given that your heel pain has progressively worsened over the past month, it is advisable to seek medical attention. You should consider seeing a healthcare provider who specializes in musculoskeletal issues, such as an orthopedic specialist or a podiatrist. These specialists can perform a thorough examination, which may include physical assessments, imaging studies (like X-rays or MRIs), and other diagnostic tests to determine the underlying cause of your heel pain.

In the meantime, there are several self-care measures you can take to alleviate your symptoms:
- Rest: Avoid activities that exacerbate your heel pain, especially high-impact exercises.

- Ice: Applying ice to the affected area for 15-20 minutes several times a day can help reduce inflammation and pain.

- Stretching: Gentle stretching of the calf muscles and plantar fascia can improve flexibility and reduce tension on the heel.

- Footwear: Ensure you are wearing supportive shoes that provide adequate cushioning and arch support. Avoid walking barefoot on hard surfaces.

- Orthotics: Over-the-counter or custom orthotic inserts can provide additional support and cushioning for your feet.

If your symptoms persist despite these measures, or if you experience severe pain, swelling, or difficulty walking, it is crucial to follow up with a healthcare professional promptly. Early diagnosis and treatment can help prevent further complications and improve your quality of life.