Definition

Heel pain is a common condition in which weight bearing on the heel causes extreme discomfort.

Cause

There are two different categories of heel pain. The first is caused by over-use repetitive stress which refers to a soreness resulting from too much impact on a specific area of the foot. This condition, often referred to as “heel pain syndrome,” can be caused by shoes with heels that are too low, a thinned out fat pad in the heel area (more common as we age), or from a sudden increase in activity. 

Plantar fasciitis, a very common diagnosis of heel pain, can be another cause of heel pain. This is usually caused from a biomechancial problem, such as over-pronation (flat feet). Anatomically, the plantar fascia is a broad band of fibrous tissue that runs along the bottom surface of the foot, from the heel through the midfoot and into the forefoot. Over-pronation can cause the plantar fascia to be excessively stretched and inflamed, resulting in pain in the heel and arch areas of the foot. Often the pain will be most intense first thing in the morning or after a prolonged period of rest. This pain may be described as ‘piercing’, ‘electric shock type’ which traverses along the foot from the heel to the ball of the foot. In the early stages of the condition the pain gradually subsides as the day progresses (acute), but the pain may become constant if the condition is not treated (chronic) causing irreversible damage. For more information on plantar fasciitis please click here. 

Treatment and Prevention

To properly treat heel pain, you must absorb shock, provide cushioning and elevate the heel to transfer pressure. This can be accomplished with a heel cup, heel cradle, or an orthotic designed with materials that will absorb shock and shear forces. When the condition is pronatory related (usually plantar fasciitis), an orthotic with effective pronation block as prescribed by a Podiatrist is required in order to prevent overuse and inflammation of the plantar fascia. Footwear selection is also an important criteria when treating heel pain. Shoes with a firm heel counter, good arch support, and appropriate heel height are the ideal choice.