How do I get rid of the pain in my heel?

 

How do I get rid of the pain in my heel

 

Heel pain occurs in different areas, sometimes just below the heel and on the sides, and sometimes just where the Achilles tendon (greatest tendon in the body that is responsible for standing on tiptoes) is attached to the heel bone, the back edge of the heel. In this article, we will review the most common cases of heel pains and their associated treatments. Here is what you will read next:

 

What are the main causes of heel pain?

In what situations is it necessary to see a doctor if you have heel pain?

How to get rid of the pain in my heel?

Heel pain treatment methods

When to see a doctor

 

 

What are the causes of heel pain?

The most common type of heel pain is the pain that is felt under the heel and is called heel spurs or 'plantar fasciitis'. On the other hand, inflammation of the Achilles tendon due to injury and strain causes pain in the back of the heel. Heel pain usually starts gradually. In most cases the pain is caused without any significant damage history and some chronic causes usually are responsible for these pains.

Many people with heel pain report that the pain intensifies when they wear flat shoes. To summarize, the most common causes of heel pain are as below:

 

Plantar fasciitis:

The most common cause of heel pain and soles of the feet is plantar fasciitis, sometimes mistakenly called heel spurs. It is a misnomer because the cause of the pain is not the spur itself but the improper living style.

Plantar fasciitis is caused by inflammation of the tissue membrane at the sole of the foot, called plantar fascia. This membrane is a thick ligament that stretches from the heel to the toe (the first band of the toes) and is one of many structures that make the arch of the sole of the foot.

When you bend your toes upwards, you actually cause the plantar fascia membrane to become stiff and stretched.

Prolonged walking, long standing, and in general putting constant pressure and tension can cause inflammation and tearing of the fibers that make up this membrane. This inflammation most commonly occurs at the weakest junction of the fascia, below the heel. However, sometimes the side edges of the heel and sole may also become sore.

In addition, stiff muscles in the back of the leg and constant rotation of the sole of the foot can also stretch and cause the inflammation of this fascia.

Overweight people with flat feet or people who are walking on rough surfaces or wearing inappropriate shoes may have heel pain. When applying pressure to plantar fascia and the inflammation continues, spurs may be formed.

 

Achilles tendonitis (inflammation of the Achilles tendon):

Achilles tendonitis is more common in athletes, especially runners who suddenly increase the intensity and duration of their workouts. In addition to runners, this complication has also been seen among middle-aged people who engage in other recreational sports such as tennis.

Achilles tendonitis pain is usually felt in the back and sometimes on the heel after the heavy exercise, especially long runs. Sometimes the pain intensifies in the morning but usually decreases with the onset of gentle daily movements and activities. It is more common in men than women.

 

Bursitis (inflammation of the bursae):

Bursae are small sacs filled with fluid that are placed around the joints like a pillow to facilitate the movement of tendons on any bony prominences as well as around the joints. Bursa inflammation is called bursitis and is one of the causes of heel pain.

 

How do I get rid of the pain in my heel

 

Osteomyelitis:

Bone infection is called osteomyelitis. Usually, the infectious agents reach the bone through the bloodstream. Untreated infections of nearby tissues can also cause bone infection. This is especially true in people with uncontrolled diabetes. Foot ulcers in diabetics which do not heal may become chronic and infectious which can make adjacent bone also infected.

Patients with osteomyelitis often experience systemic symptoms such as fever and fatigue in addition to local pain, swelling and redness. These patients cannot walk freely, and they often limp.

 

Haglund's deformity: 

In some people, the heel bone protrudes at the junction of Achilles tendon. This deformity of the back of the heel bone is called ' Haglund’s deformity '.

 

Peripheral neuropathies:

Peripheral neuropathy occurs when nerve fibers outside the brain and spinal cord are damaged. Peripheral neuropathies are irritated by pain, tingling, and numbness in the area.

Physical injuries to the nerves (accidents and trauma), infections and inflammation, metabolic diseases, diabetes, etc. can be the causes of peripheral neuropathies.

 

Paget's disease of bone:

In Paget's disease of bone, the normal cycle of bone formation and destruction is disrupted, and the bone becomes brittle and weak. Pain is the most common symptom of this disease.

 

Reactive arthritis (Reiter's syndrome):

These arthritis consist of many different types but they all create inflammation and pain in the joints in a similar way.

In all types of this kind of arthritis (note that the inflammation of joints is called arthritis), always there is some kind of infection in other part of body. For example, someone who gets urinary tract infections, may also experience pain and swelling in some of his or her joints.

Rheumatoid arthritis

Sarcoidosis

Osteoarthritis

Stress fractures:

These types of fractures are actually exceptionally fine cracks created on the bone that are caused by putting constant pressure on the bone.

 

Tarsal Tunnel Syndrome:

The posterior tibial nerve (nerve that is responsible for every feeling under foot) passes through a canal below the ankle's inside bony prominence. Any factor that puts pressure on this channel can irritate this nerve and cause a feeling of pain, tingling and burning along the nerve pathway.

 

In what cases is it necessary to see a doctor if you have heel pain?

  • Severe pain with swelling and redness

  • When you are unable to put weight on your heel and walk normally

  • Severe pain, swelling and redness of the heel accompanied by fever and fatigue.

  • When you have some accompanying diseases.

 

How do I get rid of the pain in my heel?

Considering the most common causes, you may consider trying these:

  • Change your shoe
  • Use ice pack 2 or 3 times a day
  • Take some over-the-counter pills like naproxen for up to 10 days
  • Use stretching exercise
  • Restrict your daily activities
  • Lose weight as much as you can
  • Do not carry heavy things

 

Heel pain treatment methods:

Self-medication or treatment at home:

Most cases of heel pain are caused by plantar fasciitis, tendonitis and Achilles tendon strain which improve well with the use of anti-inflammatory and analgesic drugs like Ibuprofen (Advil), or naproxen. These drugs help trating your pain by reducing inflammation and relieving pain.

Reducing physical activity:

Stopping strenuous physical activities such as participating in competitions, long runs, long-time standing, walking on uneven surfaces, etc. Reducing the pressure on the heel and the surrounding structures will reduce the irritation and inflammation and thus the pain.

Cold therapy and use of cold:

Pour some ice into the plastic bag and wrap the bag in a towel and put the towel on the heel two to three times a day each for 15 minutes.

Changing the shoe:

Get standard shoes of the right size with proper and customized insole.

Medical shoe insoles:

You can get them from reputable pharmacies. These accessories cause a uniform and coordinated distribution of the weight on the bones of the foot and heel.

 

When to see a doctor:

If, despite following the above treatment tips, your pain get worse or does not improve, you should see a doctor to check the cause of the pain. Sometimes the doctor uses a simple radiograph to check for damage to the tissues adjacent to the heel. In this photo, Haglund's deformity and sometimes stressed structures would be visible beside any spurs. Sometimes MRI may be required to evaluate osteomyelitis. Osteomyelitis can be treated with systemic injectable antibiotics and sometimes surgery.

Autoimmune diseases such as rheumatoid arthritis, sarcoidosis, etc. require more detailed tests and specialized examinations. The drugs usually used to control these diseases relieve the patient's symptoms by weakening the body's immune system.

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