CAUSES HEEL PAIN
Plantar fasciitis is the most common cause of heel pain. The plantar fascia is a ligament that attaches to the bottom of the heel and extends to the base of the toes. Weight bearing activities can overload or put tension on the plantar fascia which could cause pain and inflammation. Most commonly a sharp, stabbing pain on the bottom of your heel. The pain is usually worse when you’ve rested for a while. The pain is usually the worst when you first wake up in the morning or during the day when you start walking after a period of rest. Without early treatment, the pain can persist throughout the entire day.
Achilles tendonitis causes pain in the back of your heel. The Achilles Tendon extends down the back of your leg and inserts into the back of your heel. It is one of the strongest tendons in the body, but has a relatively poor blood supply. This makes it easier to injure and take longer to heal. If left untreated, the damage caused by chronic inflammation could cause more significant and long term damage.
A bursa is a fluid-filled sac that your body forms in an area of irritation. The bursa is supposed to naturally cushion the irritated areas. Instead, it often becomes inflamed and causes a bursitis. The bursitis can cause pain on the bottom or the back of the heel.
A heel spur is a calcification within the soft tissues that attache to the heel bone. The heel spur can be on the bottom of the heel or back or the heel. They form due to excessive pulling of the Achilles Tendon and/or the Plantar Fascia where they attach to the heel bone. They usually respond well to concervative therapies and surgery can be avoided.
A stress fracture is a hairline fracture in the heel bone. It can be so fine, that it may not been seen on x-rays (may need MRI or bone scan to confirm the diagnosis). The heel bone takes a lot of pressure, absorbing the shock from every step you take. This extra stress could lead to the formation of a stress fracture. It they are not treated early, they could lead to a more significant injury, which could require surgical intervention.
A Haglund’s Deformity is a painful bump on the back of your heel. It is formed due friction/rubbing of the back of the heel against the shoe. Pain from a Haglund’s Deformity can vary. It may only be symptomatic in certain shoe or might be so severe that you can’t wear a shoe. And in some cases, may have no pain at all.
DIAGNOSING HEEL PAIN
Since there are so many causes of heel pain, it’s important to determine the cause of yours. Normally, diagnosis is made based on the examination and x-ray findings. In certain cases, a musculoskeletal ultrasound would be performed to examine the surrounding tendons, ligaments and soft tissues. But if the x-rays and/or ultrasound are inconclusive, an MRI or bone scan may be ordered.
TREATMENTS FOR HEEL PAIN
Casting (CAM walker)
Regenerative Medicine (Amniotic or Platelet Rich Plasma injections)
Surgical Care - This is a last resort and very rare.