We are your Heel Pain Doctors! We have offices in Livonia, Novi, Howell, & Southfield to service you!
Heel calluses, also called plantar calluses, develop when one metatarsal bone is longer or lower than the others and it hits the ground with more force than it is equipped to handle-at every step. As a result, the skin under this bone thickens like a rock in your shoe. The callus causes irritation and pain.
Sometimes, an osteotomy procedure is performed to relieve the pressure on the bone. The procedure will involve cutting the metatarsal bone in a “V” shape and lifting the bone and aligning it with the other bones.
Heel fissures, or cracking of the skin of the heels, are an often painful condition that can cause bleeding. Open-backed sandals or shoes, which allow more slippage around the heel while walking, are often the culprits. The skin thickens as a result of the friction.
Plantar Fasciitis (heel spur)
Plantar fasciitis (or heel pain) is commonly traced to an inflammation on the bottom of the foot. Our practice can evaluate arch pain and may prescribe customized shoe inserts called orthoses to help alleviate the pain.
Plantar fasciitis is caused by inflammation of the connective tissue that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Also called “heel spur syndrome,” the condition can usually be successfully treated with conservative measures such as the use of anti-inflammatory medications and ice packs, stretching exercises, orthotic devices, and physical therapy.
Heel Pain: Definition, Causes, Diagnosis, and Treatment
Heel Pain – an overview
Heel pain is a common chief complaint seen in hospitals and private clinics.
According to one report, the prevalence of plantar heel pain in the population is around 9.8%. As for debilitating plantar heel pain, the numbers are not better, with up to 7.9% of the population dealing with functional disability.
The reason behind the high prevalence of heel pain boils down to the complex anatomy of the ankle region, which consists of 26 bones, 33 articulations, and around 100 tendons.
The severity of the pain ranges from mild to disabling, which is why you should consult with your doctor to get further evaluation.
In this article, we will briefly cover the causes of heel pain, such as plantar fasciitis, then switch gears to the diagnosis and treatment options.
Causes of Heel Pain
The causes of heel pain are diverse and include:
Plantar fasciitis occurs when your feet are under too much pressure.
By far, this condition is the most common cause of heel pain, with 1% of the U.S. population reporting the diagnosis.
When the plantar fascia gets stretched too far, the soft tissue becomes inflamed. The site of the inflammation is typically around the insertion of the fascia to the heel bone, which explains the pattern of the pain.
Sprains and strains
Sprains and strains are extremely common injuries that result from a process of wear and tear.
Achilles tendonitis (AT)
AT describes the active inflammation of the tendon that attaches the calf muscles to the heel. As a result, receptors in your heel send signals to the brain, leading to sensations of pain.
Bursae are fluid-filled sacs located in several areas around the body, especially your joints.
When the bursae located in your heel become inflamed, they swell up, causing pain in that region.
Also known as pump bumps, heel bumps are common in adolescents. In these subjects, the heel is not yet mature, predisposing it to the formation of bumps after excessive rubs.
The primary trigger of heel bumps is having a flat foot or wearing high heels at an early age.
Tarsal tunnel syndrome
Similar to carpal tunnel syndrome, this condition results from the entrapment of a large nerve, which triggers symptoms of neuropathy (e.g., pain, numbness).
Repetitive stress, high-intensity exercise, and heavy manual work have all been linked to stress fractures.
For instance, runners are particularly prone to stress fractures of their metatarsal bones of the foot. However, osteoporosis is a more common cause of stress fractures.
The diagnosis of heel pain
When you visit our clinic, your doctor will take your medical history and perform a thorough physical examination of the foot.
You may expect questions such as:
How much walking/standing can you do before the pain becomes too severe to move?
What type of footwear do you use on regular days and during exercise?
Do you have any concurrent medical conditions?
Are you taking any drugs to treat other diseases?
The next step is to examine and test the muscles in order to identify any dermatological or neurological conditions.
For instance, squeezing the heel help your doctor differentiate between a nerve problem, the presence of a cyst, or a bone fracture.
While these steps are usually sufficient, your doctor may need to order additional tests (e.g., blood tests, imaging scans).
After collecting information from your medical history, clinical examination, and results of tests, your doctor will pinpoint a diagnosis for your heel pain and start a treatment plan.
Treatment of Heel Pain
If you are dealing with heel pain, here are some ways to relieve it:
Avoid any form of strenuous exercise.
Apply ice on your heel for 15–25 minutes.
Take over-the-counter painkillers (e.g., acetaminophen).
Wear comfortable shoes that don’t irritate the heel.
Wear a night splint (a device that stretches the foot while you sleep).
In case these methods are unsuccessful in relieving your pain, it may be time to visit your doctor or podiatrist to get a tailored treatment approach.
After taking your history and performing a thorough physical examination, your doctor may order a foot X-ray to narrow down the cause of your heel pain. Once the etiology (i.e., cause) is clear, treating your pain becomes more effective.
In some cases, you may also need physical therapy, especially when your heel pain is chronic. This will strengthen the muscles and tendons around your foot to prevent further damage.
In extremely rare cases, your doctor may suggest undergoing surgery to repair the injury once and for all. However, this method is not always the best approach since it requires a long duration of recovery, and in many cases, heel pain doesn’t subside.
Advanced treatment at Michigan Podiatry
Extracorporeal shock wave therapy – ESWT is mainly reserved to treat plantar fasciitis by releasing high-frequency shock waves that reduce inflammation and relieve pain.
Platelet-rich plasma – throughout many research papers, scientists found that PRP accelerates recovery after traumatic injury by promoting the release of repair agents. Using PRP to treat heel pain is a fantastic way to prevent relapses.
Stem cell therapy – stem cell therapy involves the injection of cells with endless differentiation properties. These cells can repair the damaged tissues seen with several illnesses listed above and restore the lost functions.
MLS laser – the MLS Laser uses specific wavelengths of light to treat heel pain. The wavelengths stimulate the regeneration at the cellular level without putting you at risk of thermal injuries that other lasers may inflict.
Botox – you’ve probably heard of Botox as the magical substance that smooths out wrinkles and subsides signs of aging. However, the same properties of this compound (i.e., muscle relaxant) can also relieve pain and pressure when the heel area is inflamed.
Cortisone injections – injecting corticosteroids (e.g., cortisone) into the site of inflammation is one of the most efficient ways to accelerate recovery.
Minimally invasive surgical procedures – these techniques are minimally invasive, but they lead to similar results as conventional surgery. Many athletes prefer this option to get back to the competition as soon as possible.
When to see a doctor?
Simple heel pain responds greatly to home remedies that involve resting, applying ice, and taking over-the-counter (OCT) painkillers.
However, if your symptoms do not improve within 2–3 weeks, it might be time for a doctor’s visit.
In case you experience any of the following symptoms, you should contact your doctor immediately:
Severe pain that does not improve with OCT painkillers
The abrupt nature of the pain (i.e., starts suddenly)
Notable redness around the heel
Extended swelling in the heel and ankle regions
The inability to walk due to severe pain
If you live in the following areas, you can book an appointment with our excellent team of doctors at Michigan Podiatry by clicking on this link:
Heel pain prevention
Preventing heel pain through avoiding injury is the best approach to this issue. However, do not expect zero risk even after taking every precautionary measure.
Steps to Reduce Your Risk of Heel Pain:
Wear the right shoes for you, especially during exercise.
Always warm up and stretch your muscles before working out.
Pace yourself during physical activity.
Maintain a healthy diet to prevent low-grade inflammation, which is a common trigger of musculoskeletal injuries.
Take frequent breaks when you feel tired during work.
Work toward maintaining a healthy weight, as obesity increases the pressure applied on your heel.
Heel pain is a common symptom that most people experience at some point. Most patients with heel pain have faulty foot mechanics that contribute to their condition. Custom orthotics, placed in your shoes, reduce mechanical stress to your feet and help resolve painful symptoms. Our doctors at Foot Healthcare Associates, utilize precision made orthotic devices to provide our patients with the best results in resolving heel pain.
Contact Our Heel Pain Doctors Today
If you are having problems with heel pain, please contact our heel pain doctors today at 248.258.0001 to schedule an appointment in Novi, Livonia, Howell, or Southfield. Your Heel Pain treatments are covered by most insurances.
Our podiatry practice at Foot HealthCare Associates is built on three principles: trust, caring and a commitment to excellence in podiatry. We view the relationship that we have with our patients as a sacred trust. We work hard every day to deserve that trust.