Foot specialist Sean Peden, MD, an orthopedic surgeon at ONS, gets to the bottom of the question, Why does my heel hurt?
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, 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. Arthritis, wear and tear, or a build-up of uric acid in the small bones of the feet known as gout, can also cause heel pain.
In most cases, heel pain can be relieved without surgery. Rest, stretching exercises, and possibly anti-inflammatory medication can usually do the trick. If left untreated, however, a sore heel will only worsen and can develop into chronic and more problematic conditions.
For that reason, it’s important to consult with a physician or specialist to determine the underlying cause of pain in your heel that lasts more than a few days, particularly 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.
Some Common Causes
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 plantar fasciitis is left untreated, a painful heel spur (calcium deposit) can develop where the fascia attaches to the heel bone.
P
ain from behind the heel could indicate inflammation of the bursae and the Achilles tendon at the point where the tendon 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.
If you experience pain that makes it difficult to walk or enjoy your everyday activities, schedule an appointment at ONS with one of our foot and ankle specialists, Sean Peden, MD or Michael Clain, MD by calling 203-863-1145 or request an appointment here.
tendon are increasingly common in our aging yet increasingly active population. In cases where an Achilles rupture is missed or the rupture cannot be repaired directly under normal tension, adding the flexor hallicus longus tendon transfer allows for significantly improved results with a shorter recovery.
