The big question is, simply, “Why?”
Why do you have heel pain all the time? Why won’t it go away? And of course, the big big question: What can you do about it?
The truth, we’re afraid, could be more complicated than you might think. See, there are many different conditions that can cause heel pain, and a wide variety of underlying reasons for them to occur. The reason that your heels hurt may be completely different from someone else’s heel pain.
But don’t despair! The team at Capital Podiatry Associates is in your corner, and we’ll help you answer all the “why” questions so that you can get the specific, effective treatment you need.
What Are the Underlying Causes of Heel Pain?
Before we even start talking about specific conditions and diagnoses, let’s talk about the everyday actions and activities that contribute to developing heel pain. In short—the things that are causing your feet to break down in the first place.
Again, every case is unique. The mix of underlying factors that caused your heel pain may be different from those of someone else. The list below is just a sample of some of the most common—perhaps only a few apply specifically to you, or perhaps several do.
- Foot mechanics and structure. No two people have the exact same feet. And the unfortunate truth is that not all feet are equally good at absorbing shocks and protecting the heels from strain. If you have a mechanical defect, such as a flat arch, your heels may have to bear excessive force loads compared to your peers.
- Active hobbies and sports. Do you run, dance, or play sports like tennis, basketball, or soccer? Lots of high-impact activities without adequate time for rest and recovery built into your schedule can lead to heel pain.
- Certain occupations. If you are on your feet all day, walking and standing on hard surfaces, your heels are more likely to feel enough strain to eventually injure them. That’s not to say desk jobs are better, of course, but teachers, factory workers, service professionals, health care professionals, etc. will probably have to worry more about their feet.
- Poor footwear. The wrong pair of shoes will magnify any small problem with foot structure or athletic overuse and make it significantly worse. If your pair does not fit, does not provide effective support or cushioning, or is not appropriate for your chosen activity, heel pain is a very common result.
- Obesity. It’s estimated that more than 150 million Americans are either overweight or obese. The link with heel pain is obvious—simply put, the heavier you are, the more weight and stress your heels must manage for every step you take and every second you stand.
- Age. As we get older our connective tissues tend to lose strength and flexibility, and the fatty pad on the underside of the heel also tends to get somewhat thinner. Although age isn’t a cause of heel pain, exactly, these factors may lower the threshold for heel pain to develop through other causes.
Take a look at the above list of items. Do you see anything you recognize in yourself? Perhaps you are beginning to see the answer to your first question.
What Conditions Cause Heel Pain?
So now that we have a good handle on the underlying causes, we need to talk about conditions and diagnoses. Because the truth is there isn’t just one condition called “heel pain”; there are actually multiple different things that could go wrong.
In other words, it’s a question of what type of tissue, in what location, is the one that’s broken down due to all that stress. Some of the most common diagnoses include:
- Plantar fasciitis. In this case, it’s the plantar fascia—a tough band of connective tissue on the bottom of your foot—that breaks down first. Pain tends to be located underneath, and sometimes directly in front of, the heel. Also, pain tends to be worst after getting up from a rest—either sleeping or sitting for an extended period.
- Heel spurs. Plantar fasciitis that goes untreated for long enough can often cause heel spurs to build up on the front of the heel bone. These spurs may or may not be painful on their own, depending on their size and location. Usually treating the plantar fasciitis will cause all the pain to go away, but sometimes the spur itself needs to be addressed.
- Achilles tendinitis. This condition is especially common in active, middle aged individuals. Repetitive strain irritates the Achilles tendon, leading to pain, tenderness, and/or stiffness at the back of the heel.
- Bursitis. Bursae are small sacs of fluid that are designed to provide cushioning and lubrication for joints—but they can also be damaged to the point where they become swollen and painful. The most common place for this to happen in feet is at the back of the ankle (retrocalcaneal bursitis), so symptoms may be very similar to Achilles tendinitis.
- Tarsal tunnel syndrome. In this condition, pain is caused by pinched or entrapped nerves as they pass through the tarsal tunnel in the ankle. Symptoms typically present as pain and numbness centering around the heel, but can also “radiate” into the rest of the foot.
- Sever’s disease. If the person suffering from heel pain happens to be a tween or teen, odds are they have this condition. It’s caused by irritation and inflammation in the growth plate of the heel, which is more vulnerable to injury at this stage of development.
- Fractures. Most heel fractures tend to be the result of catastrophic accidents (falling from a height, auto accident, etc.). However, it’s also possible that your heel might develop tiny cracks called stress fractures due to repetitive overuse, which can cause mild to moderate pain with and after activity.
So as you can see, heel pain isn’t always as simple as it seems. A lot of things can go wrong—and if you want a treatment plan that will be safe and effective, it’s important to figure out exactly what the nature of the injury is, as well as what caused it.
And that’s where we come in.
Getting from “Why Do I Have Heel Pain All the Time?” to “My Heel Pain Is Gone for Good!”
Stop by and see us at Capital Podiatry Associates. Our team of foot and ankle experts has been helping people just like you overcome their heel pain—and keep it away—for years.
First, we’ll take care of you and make sure all your questions are answered and concerns are addressed. We’ll conduct a thorough examination and talk with you about your symptoms and experiences, so we fully understand what is wrong and how it has affected your life.
Then, we can start to put together a personalized treatment plan that fits your individual situation and needs. And the great news is that conservative treatment options, such as physical therapy and orthotics, are effective in the vast majority of cases. Foot and ankle surgery, although available as a last resort when needed, is almost never necessary for most forms of heel pain.