HEEL & ARCH PAIN

Heel & Arch Pain

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The heel is a specialised part of the body designed to absorb the impact of your body weight when walking, running or undertaking any other form of physical exertion or weight-bearing exercise. When pain develops, it can be very disabling, making every step a problem, which in turn affects your overall posture.

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Heel pain is a common occurrence. In most cases the pain is caused by some form of mechanical injury resulting from small repetitive injuries that occur at a rate faster than the body can heal them. 

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Heel pain can also be caused by lower back problems or inflammatory joint conditions.

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Here are examples of the most common types of heel pain 

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Plantar fasciitis (or fasciopathy):

This is the most common form of heel and arch pain, caused by damage to the fascia ‘band’ (similar to a ligament) which connects the heel bone to the base of the toes. This condition can be caused in various ways including extensive running, walking or standing for long periods of time, especially when you have a sedentary lifestyle. In particular, a change of surface (eg road to track), poor shoe support, being overweight, overuse or sudden stretching of your sole, as well as a tight Achilles tendon, can lead to this condition. If you get heel or arch pain first thing in the morning after getting out of bed or after a period of rest which initially eases off this could be you culprit

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Heel bursitis (subcalcaneal bursitis):

This is an inflammation of a bursa (a fluid-filled fibrous sac) under the heel bone where the pain is typically more in the centre of the heel than that experienced with plantar fasciitis and significantly worsens during the day. This condition can be caused by a fall from a height on to the heel.

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Heel bumps:

These are firm bumps on the back of the heel, usually caused by excessive shoe rubbing in the heel area, or the thickening of the tissues associated with a tight Achilles tendon.

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Tarsal tunnel syndrome:

This can feel like a burning or tingling sensation under the heel within the arch of the foot with occasional loss of sensation on the bottom of the foot. This is caused by compression of the tibial nerve as it passes the inside of the ankle. Tapping of the nerve just behind the ankle bone (known as Tinel’s test) will stimulate the symptoms of the condition. 

 

Chronic inflammation of the heel pad:

This is caused by a heavy heel strike or sometimes a reduction in the thickness of the heel pad which can give rise to a dull ache in the heel which increases during the day.

 

Fracture:

A fracture can be caused by falling from a height or landing on an uneven surface. If this is suspected, an X-ray is required to confirm final diagnosis and to determine the extent of the injury and a follow-on treatment plan.

 

Sever's disease (calcaneal apophysitis):

This painful condition affects young children, usually between the ages of 8 and 12, especially those who are physically active or undergoing a growth spurt. It results from inflammation of the Achilles tendon where it attaches to the heel. This condition is temporary and self-limiting but can be painful at the time. Rest, strapping, heel raises or orthotics may help. Depending on the severity stretching exercises may help however these are not always appropriate.

 

Achilles tendinopathy:

This condition occurs when the Achilles tendon is placed under more pressure than it can cope with and small tears develop, along with inflammation, which in some cases leads to tendon rupture. 

 

Who gets it?

Heel pain can affect everyone, whatever your age, but those more commonly affected include people in middle age (over 40s age group), those who are overweight or stand for long periods of time and athletes.

 

What are self-treatments?

Heel pain is a common condition and in most cases will diminish following some routine self-care measures. If the pain persists longer than three weeks, it is best to seek professional advice from a podiatrist, as there are many types of heel pain, each with their own different causes and separate forms of treatment. If you experience heel pain, some simple self-care measures include:

• Wear shoes with good heel cushioning and effective arch support 

• Avoid walking barefoot or in non-supportive shoes even around the house.

• Minimise walking or exercising on hard ground 

• Rest regularly and try not to walk or run too fast 

• Wear a raised heel (no more than 6-10 mm higher than normal) 

• Apply ice for 10-15 minutes after activity to reduce pain

• Take some pain relief medication if needed (always check with your GP or pharmacist before taking any new medication).

• Lose weight if you are overweight 

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When should I see a podiatrist?

Treatment for your heel or arch pain depends largely on your symptoms and the injury that’s causing it. So it’s important you get a proper diagnosis from your podiatrist. This will ensure your treatment plan is specific to your injury. The aim being to eliminate your pain as quickly as possible and prevent it from returning.