What is it about ?
Heel pain (heel pain) is usually caused by irritation of the membrane covering the sole of the foot, the plantar fascia. Inflammation of this fascia is called plantar fasciitis. The problem generally results from overwork (excess weight, running, walking, prolonged standing, …).
Heel pain is often referred to as the ‘heel spur’. But the heel spur is actually a common calcification of the fascia due to prolonged overexertion, which does not always cause pain.
Other possible causes include damage to the heel fat pad, rheumatism, compression of a nerve, bursitis, Achilles tendon problems, shoes that are too tight and fractures (eg stress) of the heel bone (calcaneus).
More rarely, heel pain can be caused by a cyst, bone inflammation, bone cancer, of the’arthritis or a fracture related toosteoporosis.
Boys between the ages of 8 and 12 can sometimes have a painful Achilles tendon lump (heel apophysitis or apophysosis or Sever’s disease).
In whom how often does it occur?
Irritation of the fascia of the sole of the foot (plantar fasciitis) is quite common, affecting 1 in 10 people and especially people who are overweight, who work upright, or who run or walk a lot. It is responsible for 80% of cases of heel pain. Half of people with plantar fasciitis also have a heel spur.
How to recognize it?
Pain due to plantar fasciitis can be felt in the middle of the foot. Usually, this is pain that occurs immediately after getting up and decreases over the course of the day. The pain increases again if you overload the foot. The point at the center of the bottom of the heel is very sensitive.
Other causes of heel pain cause pain more in the back of the heel, in the ankle, or under the Achilles tendon.
How is the diagnosis made?
The doctor will palpate your heel to determine the pain point precisely. He will move your foot to see if the pain is triggered in certain positions. If it is plantar fasciitis, a lump may be palpated.
In case of nerve compression, the pain is especially felt when the foot is held in a certain position. If the cause of the pain is not clear, the doctor may order a blood test and an x-ray or ultrasound.
What can you do ?
Above all, you need to rest and not put too much strain on the painful foot. Also give yourself plenty of time. It is not abnormal for these conditions to take a long time to heal. Often the pain goes away on its own, although it can last for several months.
You can apply a hot or cold compress to the painful area. You can practice stretching and relaxing the foot and calf by doing a few exercises several times a day, and thus relieve the pain. If necessary, you can take a painkiller.
If the inflammation recurs regularly, it is advisable to lose a few pounds if you are overweight or temporarily reduce hobbies such as running or walking. In many cases, wearing appropriate shoes (not too flat) and orthotic insoles can relieve pain. It is not recommended to walk barefoot.
What can your doctor do?
The doctor may advise you to use a silicone gel heel pad or a U-shaped insole. These devices are available from orthopedic bandagers. In some cases, it is advisable to wear a special brace at night.
If you have plantar fasciitis, your doctor may also prescribe physiotherapy sessions. If the pain does not decrease enough, it may be helpful to inject anti-inflammatory drugs or pain relievers directly into the painful area.
In the presence of severe and persistent symptoms, the general practitioner will refer you to an orthopedic surgeon or a specialist in physical medicine. An operation may be considered as a last resort.
Want to know more?
- The radiography, here, Where to find on this page of Cliniques St Luc UCL
- Ultrasound here Where to find on this page of Cliniques St Luc UCL
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