Heel pain: what it can be and what to do

There are several causes for pain in the heel, from changes in the shape of the foot and in the way of stepping, to excess weight, spurs on the calcaneus, blows or more serious inflammatory diseases, such as plantar fasciitis, bursitis or gout, for example. These causes can either cause constant pain or just when stepping, as well as appear on one or both feet.

To relieve pain, consultation with the orthopedist and monitoring by the physiotherapist are recommended, who can identify the cause, and indicate the most appropriate treatments, which may be the use of anti-inflammatory remedies, foot orthoses, realization of rest and physiotherapy techniques for postural correction, stretching and joint strengthening.

Some common causes of heel pain include:

1. Changes in the shape of the foot

Although they are rarely remembered, changes in the shape of the foot or in the way of walking are a major cause of pain in the foot, especially in the heel. This type of alterations may already be born with the person or be acquired throughout life through the use of inappropriate shoes or the practice of some kind of sport. Some examples of alterations include the flat or flat foot, varism and valgus of the hindfoot, for example.

Heel pain due to these changes usually arises from poor foot support on the floor, which ends up overloading some joint or bone, when it shouldn't.

What to do: in some cases, postural correction exercises, use of orthoses and insoles or even surgery may be indicated. However, it is necessary to follow up the orthopedist and the physiotherapist to assess the changes and plan the best treatment.

It should be remembered that women who wear heels often cause a kind of momentary "deformity" in the biomechanics of the feet, which can compromise the calf tendon and muscle, which is also a cause of pain in the heel.

2. Trauma and blows

Another very common cause for heel pain is trauma, which occurs when there is a strong blow to the foot. But trauma can also appear from wearing heels for a long time, from running an intense run for a long time or from wear on the shoes.

What to do: it is recommended to rest for a period, which varies according to the intensity of the injury, but it can be between 2 days to 1 week. If the pain persists, an evaluation by the orthopedist is necessary to see if there are more serious injuries, and the need to use anti-inflammatory drugs or immobilize the site.

A good tip to recover faster is to make cold water compresses, to reduce inflammation and swelling, in addition to choosing comfortable shoes.

3. Plantar fasciitis

Plantar fasciitis is inflammation of the tissue that lines the entire sole of the foot and is usually caused by repetitive trauma or injury to the plantar fascia, which is a firm, fibrous band that supports and maintains the plantar arch, which leads to local inflammation.

Some of its main causes include having heel spurs, standing for long periods, being overweight, having flat feet and doing excessive physical activity. This inflammation usually causes pain under the heel, which worsens in the morning when starting to walk, but which tends to improve after the first steps. In addition, local swelling and difficulty walking or wearing shoes may also occur.

What to do: Stretching the calf and sole of the foot, strengthening exercises and massage with deep friction is recommended. But more specialized treatments may also be indicated, such as infiltration with corticosteroids, radiofrequency in the area or use of a splint to sleep. Some exercises include wrinkling a towel lying on the floor and picking up a marble. Better understand what is plantar fasciitis and how to treat it.

4. Heel spur

The spur is a small fibrous projection that forms on the heel bone and that results from intense pressure and overload on the sole of the foot for long periods of time, so it is more common in people over 40, people with excess of weight, who use inappropriate shoes, who have some kind of deformity in their feet or who practice very intense running, for example.

Those who have spurs may experience pain when standing up or stepping, which is common in the morning. In addition, it is very common that the spur is associated with the appearance of plantar fasciitis, as the inflammation of the heel can extend to nearby structures.

What to do: Spur treatment is usually done when there is local inflammation, especially when together with plantar fasciitis, the use of ice, rest and use of anti-inflammatory drugs, as advised by the doctor, is recommended. These measures are usually sufficient, and surgery to remove the spur may be indicated, but it is rarely necessary. See some homemade strategies in this video:

5. Heel bursitis

The bursa is a small pouch that serves as a shock absorber and is located between the heel bone and the Achilles tendon, when this inflammation there is pain in the back of the heel, which worsens when moving the foot.

This inflammation usually arises in people who exercise or are athletes, after a sprain or bruise, but it can also happen due to Haglund's deformity, which occurs when there is a bony prominence in the upper part of the calcaneus, causing pain near the Achilles tendon.

What to do: it may be necessary to take anti-inflammatory drugs, use ice packs, decrease training, do physiotherapy sessions, stretches and exercises. Check out more details on the treatment of bursitis.

6. Sever's disease

Sever's disease is pain in the region of the growth plate of the calcaneus that affects children who practice impact exercises such as running, jumping, artistic gymnastics and dancers who dance in need of jumping on tiptoes. Better understand what this disease is and why it happens.

What to do: you must reduce the intensity of your workouts and jumps to avoid aggravating them, in addition it can also help to place some ice cubes wrapped in a napkin for 20 minutes on the spot and use a heel to support the heel inside the shoes. In addition, to avoid aggravating the pain, it is also advisable to always start training with 10 minutes of walking.

7. Drop

Gout, or gouty arthritis, is an inflammatory disease caused by excess uric acid in the blood, which can accumulate in the joint and cause inflammation and severe pain. Although it is more common in the big toe, gout can also appear on the heel, since the feet are the main sites for the accumulation of uric acid.

What to do: The treatment for gout attacks is guided by the doctor, and involves anti-inflammatory drugs, such as ibuprofen or naproxen. Then, it is necessary to follow up with the rheumatologist, who can also prescribe medication to control the levels of uric acid in the blood to prevent new crises and prevent complications. Better understand what it is and how to identify gout.

How to know the cause of my pain

The best way to know the cause of the pain in the heel is to try to find the exact location of the pain and try to identify some cause, such as having increased physical activity, starting a new sport, hitting that place or something like that. Placing a cold compress on the site of pain can relieve symptoms as well as soaking your feet in a bowl of hot water.

If the pain persists for more than 1 week, you should go to the orthopedist or physiotherapist for the cause to be identified and treatment to be started.