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“Feet are physiologically designed to handle the pressure…to a point,” said orthopedic foot and ankle specialist, Mark Yakavonis, MD, Orthopaedic & Neurosurgery Specialists (ONS). Repeated pounding on a hard surface while running, participating in sports or wearing ill-fitting shoes that inflame the foot’s tissues can cause pain on the bottom of your heel or behind it, said Dr. Yakavonis. 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, Dr. Yakavonis warned, a sore heel may worsen and develop into chronic and more problematic conditions.
For that reason, it’s important to consult with an orthopedic foot and ankle physician to determine the underlying cause of pain in your heel if it lasts more than a few days. A medical consultation is particularly important if the pain 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
According to Dr. Yakavonis, 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.
Pain 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 retrocalcaneal 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 with an orthopedic foot and ankle specialist at ONS by calling 203-863-1145 or request an appointment online.
ONS has offices in Greenwich and Stamford, Connecticut and Harrison, New York, with after-hours walk-in urgent ortho care available at the Greenwich office.
