There are various reasons why you get heel pain and it is necessary to diagnose the exact cause or causes of your heel pain so that a more focused treatment can be given for cure.
Diagnosing the cause of heel pain
Your doctor will begin by asking you about the history of sudden changes in your lifestyle that can cause heel pain.
It could be about your occupation that requires long hours of standing or a sudden adaptation to an exercise program of intense activity.
He will want to check your shoes, whether they have high heels and whether they support your foot arch well, or whether they are causing extra strain on your plantar fascia.
No lab tests are indicated for heel pain except when health conditions such as rheumatoid arthritis are suspected.
Imaging tests such as a plain X-ray of the heel may show a calcaneal spur, though many patients with the calcaneal heel spur have no heel pain.
However, an X-ray of the heel or if necessary an MRI or ultrasound can help detect stress fracture of the heel. These can show soft tissue problems that X-rays do not show.
Treatment
Treatment to cure heel pain aims to remove or cure the cause of the pain. For example, wearing the wrong footwear or sudden resumption of intense physical activity have to be corrected.
Most cases of heel pain get better over time with conservative treatments. The main aim of treatment is to treat the inflammation to stop the pain, remove stiffness, and improve the flexibility of the ligaments of the foot to minimize the stress on your heel.
Home remedies
- Avoid standing for long periods, and try to rest as much as possible.
- Apply an ice pack to the painful area for 10 minutes every 2 hours. If an ice pack does not help, you can try using a heating pad with low heat. You can also soak your feet in warm water with a few drops of lavender oil.
- For heel pain relief, you can take OTC anti-inflammatory analgesics like ibuprofen or acetaminophen. They relieve pain and inflammation.
- If you have heel pain, wear shoes that are comfortable to walk in. They should be wide-toed so that tightness is not felt at the front of the foot. They should have a low heel and you should consider using soft padded insoles or heel pads. The shoe should be such so as to support the arch of the foot.
- Try gentle heel-stretching exercises to loosen the tensed-up tendons and muscles of the foot. For this, take the advice of your physiotherapist.
- Lightly massage the painful area for about 10 minutes with warm oil.
- Doctor-designed foot orthoses, commonly known as orthotics, are specially designed shoe inserts that help support the arch of the foot and control the alignment of your foot.
- With the permission of your doctor, wear a night splint while you sleep to stretch the plantar fascia and the Achilles tendon of your foot. This will help relieve the pain and relax the plantar fascia ligament faster.
Medical treatment options
Home treatments give relief from heel pain most of the time, sometimes, they may not give the desired results. The doctor may then advise more aggressive treatments. They may include:
- Steroid injections. Steroid injection may give slight relief from the persistent heel pain over the next few days and it may continue to work for several weeks to months. However, though steroid injections give symptomatic relief, they don’t cure plantar fasciitis. The injections are usually given up to three times a year. Repeated injections can damage the plantar fascia.
- Surgery: This is the last resort the doctor takes when conservative treatments are not offering relief. There are several different surgical procedures for different causes of heel pain. For example,
- Plantar fascia release. A procedure called a plantar fascia release involves partial resection of the fascia to reduce the stress on the planter tissue.
- Heel spur removal. This surgery removes the calcium deposit that forms as a heel spur.
After surgery, it can take up to six weeks to recover from plantar fascia release surgery, and up to three months to recover from heel spur removal.
How to prevent heel pain?
Heel pain mostly occurs due to the over-stretching and subsequent inflammation of the foot ligaments, more commonly the plantar fascia and the Achilles tendon.
There are various reasons why this happens. Preventing these causes from affecting you could be the first step you could take toward heel pain prevention.
Here are some measures you can adopt to prevent injury to the heel and its tissues and prevent heel pain:
- Wear properly chosen walking shoes and if you are hiker, choose your hiking boots well. The right shoes will provide cushioning to your heel and support the arch of your feet. Get rid of worn-out shoes.
- Using Custom Orthotics is beneficial for prophylactic use as well as curative. Custom orthotics are custom-made especially for you. They match the contours of your feet and are designed to correct any walking defect you may have. This helps prevent injury to the foot.
- Before starting any physical activity either for exercising or competitive sports, you should warm up. In a warm-up, you perform gentle stretching of your body muscles to prepare them for more intense physical activity later. It helps prevent injury besides improving performance. Additionally, it prevents muscle stiffness, which can help prevent injury. For example, you could walk around a bit or do some slight jogging before taking up your long-distance running or sprinting. Stretching the calf muscles and the tendons of your feet before intense exercise is important to prevent heel pain.
- Do not continue with any physical activity such as running if you are fatigued. Similarly, give your body sufficient rest if you have any pain. This is important to prevent injury to the muscles and ligaments of the legs.
- Similarly, do not suddenly start a vigorous running or long-distance marathon if you have been out of practice for some time.
- To maintain strong muscles, bones, and ligaments, you need to maintain a healthy diet. Your diet should give you enough proteins, healthy fats, carbs, vitamins, and minerals. Take supplements if needed.
- If you are overweight or obese, reduce your weight with a properly prescribed weight loss program.
