The foot has more than 30 different joints. If you consider the tons of stress your feet endure from walking and standing day in and day out, it’s a wonder everyone doesn’t suffer from some sort of heel pain, which is the most common problem affecting the foot and ankle.
Feet are physiologically designed to handle the pressure … to a point. Repeated pounding on a hard surface while running or participating in another sport, or wearing ill-fitting shoes that inflame the foot’s tissues can cause pain on the bottom of your heel or behind it, for instance. Arthritis from years of wear and tear, or possibly from gout, (a build-up of uric acid in the small bones of the feet), can also cause heel pain.
In most cases, you can relieve heel pain without surgery. Rest, stretching exercises, and possibly anti-inflammatory medication can usually do the trick. Left untreated, however, a sore heel will only worsen and can develop into chronic and more problematic conditions.
Consult with a specialist to determine the underlying cause of pain in your heel if it lasts more than a few days. You should also consult with a specialist if it intensifies when you put weight on the foot, if there are signs of infection or injury, such as swelling, discoloration or fever, or if your heel is warm to the touch.
Pain centered under your heel could occur if you’ve bruised the heel pad by stepping on a hard object such as a rock, or from repetitive pounding on hard surfaces during sports. This pain usually goes away over time with rest.
If the pain beneath your heel is mild at first but then flares up when you take your first steps in the morning, you may have plantar fasciitis, which is inflammation of the tissue band (fascia) that connects the heel bone to the base of the toes. Plantar fasciitis is the most common condition causing heel pain. If you do not treat plantar fasciitis, a painful heel spur (calcium deposit) can develop where the fascia attaches to the heel bone.
Pain from behind the heel could indicate inflammation of the bursae or the Achilles tendon in the area of where goes into the heel bone. Achilles tendonitis and associated pain from retrocalaneal bursitis can build slowly over time, causing the skin to thicken, become red and/or swell. In some cases, a bump that feels warm to the touch can develop at the back of the heel. If pain increases with the start of an activity after a period of rest or if it is too painful to wear shoes, your physician may order an x-ray to determine if a bone spur has developed.
Injuries to the nerves in the foot can also produce heel pain. Neuropathy, or nerve damage, and Tarsal Tunnel Syndrome, in which the large nerve in the back of the foot becomes pinched and inflamed, are the two most common nerve-related conditions.