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Common Causes of Heel Pain

By Jennifer Spector, DPM, Podiatrist
The Chester County Hospital

Published: November 10, 2008

Heel pain is one of the most common causes of foot and ankle related pain, and it is seen several times a week in our office, if not several times a day. It can come on suddenly, as with an injury, or slowly over time. Regardless of the origin, heel pain can put a damper on your daily activities and affect your overall quality of life. The good news is there are many effective treatments available for reducing and eliminating your heel pain.

Plantar fasciitis is perhaps one of the most common causes of heel pain, affecting more than one million Americans each year. It is an inflammation of the band of tissue on the bottom of your foot running from your heel to your toes. Due to any number of reasons - change in activity, change in shoes, change in weight, injury, pre-existing foot type or other factors - this band of tissue becomes inflamed and sore where it inserts into the heel bone. A heel spur may or may not be associated with plantar fasciitis, but generally does not change the course of treatment. Plantar fasciitis tends to feel worst first thing in the morning when rising or when beginning activity after a period of rest.

Achilles Tendonitis often manifests as pain in the back of the heel. Your Achilles tendon is the band of tissue connecting your calf muscles to your heel bone. Chronic weakening of the Achilles tendon from tendonitis, certain medications or injury can put a person at risk for Achilles rupture, the injury most recently sustained by Misty May-Treanor on "Dancing with the Stars."

Sever's Disease is a common cause of heel pain in children. Our heel bones do not completely develop until at least age 14. Until this time, too much stress on the growth plate of the heel bone and surrounding muscles can cause inflammation and pain in the heel. It occurs more often in athletic or overweight children, and will often hurt to walk or play sports.

Skin issues such as cracked, dry skin on the heels can lead to pain in this area as well. Fissures or cracks can form from wearing open-backed shoes, increased weight, or other sources of increased friction. Diabetes or change in nerve function, such as neuropathy, can also lead to skin changes on the feet and heels. If left untreated, the cracks could open more, bleed and be at risk for infection.

Heel fractures can be very serious, especially if they involve the surrounding joints. The heel bone is made up of a thin shell surrounding a spongy center. If the shell cracks or is otherwise disrupted, the bone can become unstable. The most common injury leading to a heel fracture is a fall from a height, such as stairs or a ladder.

There are many causes of heel pain other than those discussed here. To learn more, contact your local podiatrist, or browse the foot and ankle information on www.apma.org or www.footphysicians.com.

Last Updated: 7/27/2009