Heel pain is often characterised by tenderness or swelling at the back of the heel bone (the calcaneus). Injury can occur through excessive running, jumping or trauma to the back of the heel. Common problems include bursitis, Sever's disease or rupture to the Achilles tendon.

Causes of heel pain

The heel is the largest bone of the foot and is designed to support the weight of the body and absorb the impact of striking the ground. Heel pain is usually mild and clears up on its own but persistent pain is a sign of a chronic problem. There are a number of causes of heel pain but the most common are listed below.

Plantar Fasciitis
The ligament that connects the heel bone to the ends of the toes is known as the plantar fascia and when it's strained beyond its normal range the soft tissue fibres around it become inflamed (typically at the point where the ligament attaches to the heel bone).

A foot which flattens when standing or on impact with the ground can cause plantar fasciitis and the condition is common in people who spend all day on their feet in shoes with poor support. People who are overweight or obese are also prone to this type of heel pain.

Heel bursitis
Under the heel bone is a small fibrous sac filled with fluid known as the bursa. When this sac becomes inflamed, pain is felt on the inside of the heel or at the back. There may also be swelling either side of the Achilles tendon.

Heel bumps
Sometimes referred to as 'pump bumps', this condition is common in adolescents whereby the heel bone is rubbed creating excess bone growth. This occurs because the feet haven't developed fully and therefore flatten when standing or on impact with the ground. Girls who wear high heels too soon are prone to heel bumps.

Severs disease
This is a condition which affects 8-12 year-old children and occurs when a segment of the heel bone becomes inflamed through excessive pulling.

Achilles tendonosis
When the Achilles tendon is overstretched or placed under excessive tension, small tears develop causing pain and inflammation.

Other common causes of heel pain include tarsal tunnel syndrome and stress fractures.

Symptoms of heel pain

Depending on the type of heel problem, pain will be felt in different areas of the foot. Heel pain typically begins gradually and can ease during physical activity only to return when resting.

If heel pain is sudden, severe and accompanied by a snapping or “gun-shot” type sound you may have suffered a ruptured Achilles tendon and you should seek medical attention immediately.

Diagnosis of heel pain

The majority of heel pain is mild and will ease after a few days. If symptoms persist or the pain is severe then you should visit your GP for an initial assessment to determine the extent of the problem.

Your GP may refer you to a foot specialist (known as a podiatrist) who will examine you walking and standing. If necessary, you may be sent for an X-ray or blood tests.

*Source: GoToSee.co.uk

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