What Causes Heel Pain?

There are a multitude of causes for heel pain.  The most common cause is a condition called plantar fasciitis, which is an inflammation of a ligament under the foot.  This ligament runs from the heel bone to the ball of the foot.  Most people will complain that they have pain when they get up in the morning and after rest, but there is some relief after walking for a few minutes.

causes of heel pain

What happens is that over time, this ligament gets very tight and is constantly pulling on the heel bone.  This constant and aggressive pulling causes the ligament to become inflamed and causes pain.  In the morning or after rest, the ligament contracts and becomes shorter and tighter.  As you walk, you are stretching out the ligament, thus decreasing the amount of pull on the heel bone.

However, too much walking will cause the ligament to become inflamed again.  In these cases, there is pain throughout the day.  This condition occurs in people who tend to over-pronate in their gait.  This means our feet have a tendency to roll inward, toward each other, in a motion that we call pronation. When feet pronate, they flatten, stretch out and the arch elongates. This causes excessive pulling on the Plantar Fascia ligament and attachment of the ligament to the heel bone begins to separate.

An injury occurs where the ligament progressively tears off of the heel, fiber by fiber. Bleeding occurs next to the bone and inflammatory fluids accumulate between the ligament and the bone, forming a Bursitis, or fluid-filled sack. Over time, the body lays down scar tissue, in an attempt to "glue" the detached ligament fibers back on to the bottom of the heel bone.

This condition should not be taken lightly as it can become very debilitating.  Joe DiMaggio was placed on the disability list one year for two months with this condition.  The good news is that there are many conservative ways to treat this condition, and if Joltin' Joe were alive today, he would be playing within a couple of weeks.

Other Causes of Heel Pain are the Following:

1) Sever's Disease-an inflammation of a growth plate in children.
2) Inflammation of the Achilles tendon, known as Achilles Tendinitis.
3) Rheumatoid Arthritis.
4) Stress Fracture of the heel bone.
5) A very rare bone tumor.
6) A bone bruise
7) Pinched nerve in your back along L5-S1 region.
8) Tarsal Tunnel Syndrome-An entrapped nerve along the inside of your ankle.
9) Gout


When You Need to See a Doctor

Because there are so many causes for heel pain, one should not avoid treatment or even try to self-diagnose.  If you get pain, and it does not go away within two-three weeks, one should see a podiatrist as soon as possible.  It is a well known fact that the sooner you treat heel pain, the faster it goes away.  In addition, patients who require surgery for this condition are the ones that usually wait months before seeking treatment.

heel pain surgery

Peter Wishnie, D.P.M.
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Owner of Family Foot & Ankle Specialists in Piscataway and Hillsborough, NJ. Make an appointment today!