Foot Conditions That Cause Heel Pain

Foot pain can be a distressing and debilitating condition that affects people of all ages and lifestyles, from athletes pushing their limits to someone leading a more sedentary lifestyle. In this article, we shed light on the top five causes of heel pain, including the common symptoms and a range of treatment options, such as conservative measures and in-office interventions, to help you find relief.

Plantar Fasciitis

Plantar fasciitis is one of the most frequent causes of heel pain. This common foot condition involves inflammation and irritation of the plantar fascia, a thick tissue connecting the heel bone to the toes.

Symptoms:

• Pain in the heel or bottom of the foot, typically near the front of the heel.
• Sharp or stabbing pain that’s usually worse in the morning or after periods of rest. 
• Exacerbated pain after walking or prolonged standing.

Causes:

The most common cause is a repetitive strain on the plantar fascia, such as excessive running and walking or wearing footwear without arch support. Being overweight or having tight calf muscles, high arches, or flat feet can also be contributing factors.

Treatment:

Treatment for plantar fasciitis aims to reduce pain, promote healing, and prevent recurrence. It includes:

• Performing physical therapy and stretching exercises.
• Using orthotics or shoe inserts.
• Wearing properly fitting shoes
• Applying ice or using nonsteroidal anti-inflammatory drugs (NSAIDs).
• Undergoing extracorporeal shockwave therapy (ESWT).
• Receiving corticosteroid injections. 
• Getting platelet-rich plasma (PRP) injections.

Morton’s Neuroma

Morton’s neuroma is a painful condition where the nerves in the foot become inflamed. This impacts the area between the third and fourth toes, although it can also occur between other toes. 

Symptoms:

• Sharp, burning pain in the ball of the foot. 
• Feeling as though you have a pebble or lump under your foot. 
• Tingling or numbness. 
• Discomfort that worsens with walking, wearing tight or narrow shoes, or when pressure is applied.

Causes:

The exact cause of Morton’s neuroma is not fully understood, but it’s believed to develop due to irritation, compression, or nerve injury. Contributing factors include wearing tight or high-heeled shoes that squeeze the toes together, engaging in activities that put repetitive stress on the foot, or foot deformities such as bunions and high arches. Many patients also have very thin fat padding under the ball of the foot, and wearing no shoes or less supportive shoes can cause irritation to the nerves. 

Treatment:

Treatment for Morton’s neuroma aims to relieve pain and reduce pressure on the affected nerve. It includes:

• Performing physical therapy and stretching exercises.
• Wearing shoes with a wide toe box and low heel.
• Using shoe inserts or orthotics.
• Getting alcohol sclerosing injections that target the nerve tissue.
• Administering corticosteroid injections or NSAIDs.
• Applying ice packs. 
• Surgical removal of the neuroma (neurectomy) in severe cases.

Achilles Tendinitis

Achilles tendinitis is characterized by inflammation and irritation of the Achilles tendon, the large tendon at the back of the leg joining the calf muscles to the heel bone.

Symptoms:

• Pain and stiffness in the Achilles tendon. 
• A dull ache or a burning sensation. 
• Pain that worsens during physical activity, in the morning, or after periods of rest. 

Causes:

Achilles tendinitis develops due to repetitive stress or overuse of the Achilles tendon. It can result from running and jumping, having tight calf muscles, or wearing ill-fitting footwear. Inadequate warm-ups or stretches before exercise and certain underlying foot mechanics or structural abnormalities can also be factors.

Treatment:

Treatment for Achilles tendinitis aims to relieve pain, reduce inflammation, and promote healing of the tendon. It includes:

• Rest, ice, compression, and elevation therapy. 
• Physical therapy and stretching exercises.
• Heel lifts or shoe inserts.
• NSAIDs. 
• Applying ice packs. 
• ESWT. 
• PRP injections. 
• Surgery in severe cases to remove damaged tissue or repair the tendon.

Bunions

A bunion is a foot deformity occurring when the big toe gradually deviates toward the other toes, causing the joint to protrude outward. While the primary location of the pain is typically the base of the big toe, the deformity can alter foot mechanics and cause additional strain on the heel.

Symptoms: 

• A bony bump at the base of the big toe. 
• Pain and tenderness at the bunion site. 
• Swelling and inflammation around the joint. 
• Redness or soreness of the skin. 
• Restricted movement of the big toe. 
• Strain or pain in the heel.
• Corns or calluses. 

Causes:

Bunions can be caused by structural abnormalities of the foot which overpronates and allows the bones to move out of place. While tight, narrow, or high-heeled shoes can often aggravate foot pain these types of shoes do not cause the issues. Activities that put repetitive stress on the foot and toes, such as ballet or sports, can contribute to bunions, as can rheumatoid arthritis and neuromuscular disorders.

Treatment:

Treatment for bunions aims to relieve pain, slow the progression of the deformity, and improve foot function. It includes: 

• Physical therapy to improve strength and flexibility.
• Wearing comfortable shoes with a wide toe box.
• Bunion pads or splints. 
• Corticosteroid injections or NSAIDs.
• Applying ice packs. 
• Surgery (bunionectomy) to realign the bones in severe cases.

Ingrown Toenails

Ingrown toenails develop when the edge of the nail grows into the surrounding skin, leading to pain, swelling, and potential infection. They commonly affect the big toe but can occur in any toe. Ingrown toenails can be a recurring issue for some and may require medical intervention.

Symptoms:

• Pain and tenderness along the edge of the nail. 
• Redness, swelling, and inflammation. 
• Increased sensitivity to touch. 
• Pus or drainage in severe cases. 
• Difficulty walking or wearing shoes.

Causes:

Cutting your toenails very short or round can cause the nails to grow into the surrounding skin. Stubbing the toe or repetitive pressure on the toenail can also lead to ingrown nails. Other factors include having naturally curved toenails or wearing shoes that crowd or exert pressure on the toes.

Treatment:

Treatment options vary depending on the severity of the condition, and you can manage mild to moderate cases at home. Treatment includes the following measures: 

• Proper trimming of the toenails.
• Wearing open-toed or loose-fitting shoes.
• Soaking the foot in warm water several times a day.
• Applying antibiotic ointment or taking antibiotics for infection.
• Using dental floss to lift the nail and promote proper growth. 
• Undergoing surgery in severe cases to remove a portion of the affected nail.

If you have severe pain or a worsening infection and home remedies are unsuccessful, we recommend getting advice from a podiatric specialist.

How to Deal With Your Foot Pain

Don’t ignore foot or heel pain, as this can exacerbate the symptoms. We recommend seeking medical attention if you experience persistent heel pain or suspect you have any of the above conditions. Our team of orthopedic specialists can provide a proper diagnosis and recommend a suitable treatment plan for you.