Heel pain can have many causes. See your doctor right away to determine the cause and get treatment. Tell the physician exactly where the pain is and how long the pain has persisted. Your doctor will examine the heel, looking and feeling for signs of tenderness and swelling. A patient may be asked to walk, stand on one foot or do other physical tests that help the doctor pinpoint the cause of the sore heel. Conditions that cause heel pain generally fall into two main categories: pain beneath the heel and pain behind the heel.
If pain is under the heel, one or more conditions could be the cause of inflammation of the tissues on the bottom of the foot.
*Bruise - Stepping on a hard object such as a rock or stone can bruise the fat pad on the underside of the heel. It may or may not look discolored. The pain goes away gradually with rest.
*Plantar Fasciitis - Doing too much running or jumping can inflame the tissue band (fascia) connecting the heel bone to the base of the toes. The pain is centered under the heel and may be mild at first, but flares up when taking the first steps after resting overnight.
Treatment - Special exercises, medication, and wearing a heel pad may reduce swelling.
*Heel Spur - When plantar fasciitis continues for a long time, a heel spur (calcium deposit) may form where the fascia tissue band connects to the heel bone. A doctor may take an X-ray to see the bony protrusion, which can vary in size.
Treatment - Treatment is usually the same as for plantar fasciitis. This involves rest, special stretching exercises, and wearing heel pad shoe inserts.
If pain is behind the heel where the Achilles tendon inserts into the bone, the tendon or bone may be inflamed. People often get this by running too much or wearing shoes that rub or cut into the back of the heel. Pain behind the heel may build slowly over time, causing the skin to thicken and swell. A bump may develop on the back of the heel that feels tender. The pain flares up when you first starting an activity after resting. It often hurts too much to wear normal shoes. An X-ray may be needed to detect a bone spur.
