Heel Pain: Causes, Symptoms, and Treatment Options

Heel pain

Hello, doctor.
Two years ago, after wearing high heels and walking around all day, I have been experiencing frequent pain in my heel whenever I stand for a prolonged period (the pain becomes noticeable after about two hours of continuous standing).
When the pain occurs, it is quite unbearable, regardless of whether my foot is on the ground.
There is a specific point on the heel (the bottom part) and the inner side of the heel that is extremely painful when pressed, but pressing on that point seems to slightly relieve the pain in the bottom of my foot.
I'm not sure what kind of issue this might be.
I searched online and it seems somewhat similar to plantar fasciitis, but it doesn't feel exactly the same.
Also, if I go to the hospital, should I see a rehabilitation specialist? Thank you for your response, doctor.

SUL, 20~29 year old female. Ask Date: 2013/07/27

Dr. Chen Wayda reply Rehabilitation

It is plantar fasciitis; you should see a rehabilitation specialist.

Reply Date: 2013/07/27

More Info

Heel pain can be a frustrating and debilitating condition, often impacting daily activities and overall quality of life. Based on your description, it sounds like you may be experiencing symptoms consistent with plantar fasciitis, a common cause of heel pain, particularly after prolonged standing or activity. However, there are several potential causes of heel pain, and understanding them can help guide appropriate treatment.

Causes of Heel Pain
1. Plantar Fasciitis: This is the most common cause of heel pain, 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. Symptoms typically include sharp pain in the heel, 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. Pain is usually felt at the back of the heel and may worsen with activity.

3. Heel Spurs: These are bony growths that develop on the heel bone, often associated with plantar fasciitis. They can cause pain when walking or standing.

4. Bursitis: Inflammation of the bursa (a small fluid-filled sac) at the back of the heel can lead to pain, especially when pressure is applied.

5. Tarsal Tunnel Syndrome: This occurs when the tibial nerve is compressed as it passes through the tarsal tunnel near the ankle, leading to pain, tingling, or numbness in the heel and foot.

Symptoms
The symptoms of heel pain can vary depending on the underlying cause but often include:
- Sharp or stabbing pain in the heel, especially with the first steps in the morning or after sitting for long periods.

- Pain that worsens after prolonged standing or activity.

- Tenderness or discomfort when pressing on specific areas of the heel.

- Swelling or inflammation around the heel.

Treatment Options
1. Rest and Ice: Reducing activity levels and applying ice to the affected area can help alleviate pain and inflammation.

2. Stretching Exercises: Stretching the calf muscles and the plantar fascia can help relieve tension and improve flexibility. Exercises such as calf stretches and toe stretches are beneficial.

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

4. Footwear: Wearing supportive shoes with good arch support and cushioning can significantly reduce heel pain. Avoiding high heels or shoes with inadequate support is crucial.

5. Physical Therapy: A physical therapist can provide tailored exercises and treatments to strengthen the foot and improve mobility.

6. Medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation.

7. Injections: In some cases, corticosteroid injections may be recommended to reduce inflammation and provide temporary relief.

8. Surgery: If conservative treatments fail after several months, surgical options may be considered, particularly for severe cases of plantar fasciitis or heel spurs.

When to See a Doctor
If your heel pain persists despite home treatments or worsens over time, it is advisable to consult a healthcare professional. A visit to a rehabilitation specialist or a podiatrist would be appropriate, as they can conduct a thorough examination, possibly including imaging studies, to determine the exact cause of your pain and recommend a tailored treatment plan.

In summary, heel pain can stem from various causes, with plantar fasciitis being a leading contender based on your symptoms. Proper diagnosis and treatment are essential for effective relief and recovery. If you suspect plantar fasciitis or another condition, seeking professional advice will help you get back on your feet comfortably.

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