Other Causes of Heel Pain (but not Plantar Fasciitis)

 

The most frequent cause of heel pain is plantar fasciitis and heel spurs, and this is what most GP’s and podiatrists will look for first. There are, however, many other causes of heel pain and they include the following:

Sciatica

Sciatica is an uncomfortable condition involving the sciatic nerve, which ends in the heel of the foot. If the nerve gets pinched in the sacroiliac or lower back region the pain will be felt in the heel. This is called ‘referred pain’ and it can be debilitating. The majority of techniques used to treat plantar fasciitis will not be effective in treating sciatica.

Arthritis

If a person is already suffering from arthritis and both feet are hurting as well, the source of their heel pain could be another form of arthritis. Some, but not all, of the treatments used for plantar fasciitis will help reduce heel pain caused by this condition.

Tendonitis

Inflammation of the tendons in the foot, especially the Achilles tendon, is one of the most common causes of heel pain after plantar fasciitis and heel spurs. Many of the treatments used for plantar fasciitis and heel spurs can be effectively used for tendonitis, including rest, ice, and the use of anti-inflammatories.

Damage to the Long Plantar Ligament

Injury to the long ligament will cause foot and heel pain but unlike plantar fasciitis the foot will not be sensitive to the touch; the pain will be deeper in the appendage. This type of injury is treated the same way that plantar fasciitis is treated, with the exception of the surgery performed as plantar fasciitis release surgery make things worse in long ligament injuries.

Stress Fracture

Stress fractures are not always immediately identified and are more common in flat feet than feet with sufficient arches. While many of the treatments are similar to those used for plantar fasciitis, such as rest, ice and a good heel pad, medical treatment should be sought so the foot can be protected and immobilized in order to avoid an actual breakage of the bone.

Tarsal Tunnel Syndrome

This is essentially carpal tunnel syndrome in the foot; the tarsal tunnel is made of ligaments and bones and tendons and nerves pass through it. Pain of this type occurs when these tendons become inflamed. Not only is the inflammation painful but it puts significant pressure on the surrounding nerves, which cause a dull pain in the heel and the bottom of the foot. It may also cause a numb and/or tingling sensation as well. This syndrome is often treated with arch supports in the shoe, cortisone injections or as a last resort, surgery.

Reduction of Tissue in the Heel Pad

This type of pain is usually found in elderly patients when the resilient tissue in the heels loses volume due to the aging process. Treatment usually consists of the insertion of high quality orthotics in the shoe to cushion the foot and reduce the force of impact when walking.

Bursitis of the Heel

Inflammation of the bursa sac covering the heel can be caused by plantar fasciitis but usually occurs when a person has an unusually thin heel pad. The treatment for both afflictions is quite similar, with the emphasis on the use of heel pads and anti-inflammatories. Surgery may be an option but injections are usually avoided as this can cause a complete rupture of the plantar fascia.

Sever’s disease

This condition is found in children between the ages of 8-12 years old (this is a rough estimate as it can be found in children both slightly younger and slightly older.) It is caused by high activity coupled with quick and active growth of the heel bone. Some of the treatments are similar to those used with plantar fasciitis but with Sever’s disease time is the only real cure.

Sacral Radiculopathy Nerve Compression

This type of discomfort occurs when there is a trapped nerve in the spine. This can cause pain, numbness, tingling, and weakness all along the nerve path and into the foot. Treatment is different from the techniques used for plantar fasciitis and may include physiotherapy, medication, and gentle spinal manipulations.

Tibialis Posterior Tendonitis

This affliction occurs when the posterior tibial tendon is inflamed or has been torn. Because the tendon then fails to provide adequate support for the arch of the foot, a case of flatfoot (and the corresponding foot pain that accompanies this condition) is the usual result. Orthotics and braces are the front line treatments and surgery is performed only if these treatments fail to provide relief.

Excessive Standing

Many patients who experience heel pain stand on their feet for the majority of the day. If the amount of time spent standing cannot be reduced then orthotic inserts should be used to provide extra cushioning and support for the feet and arches, and any excess weight should be lost.  Taping the foot may bring relief as will regular stretching of the feet and the calf muscles. Placing thick rubber mats in the work space can also provide substantial relief.

Body Weight and Plantar Fasciitis

Being overweight is one of the most common factors and major causes in the development of foot and heel pain. Studies show that obese people (having a BMI greater than 30) are five and half times more likely to develop pain than people with a BMI of 25 or less.

Women are more likely to experience this type of discomfort as extra weight usually develops lower on the body than it does with men and thus lowers the centre of gravity. Having a lower centre of gravity affects balance and the distribution of pressure throughout the feet, which can lead to increased pain. Having a lower centre of gravity also demands more flexible calf muscles so weight increases may initially cause pain because the calf muscles are not flexible enough to accommodate this shift in the gravitational centre.

Unfortunately, people who are overweight are at increased risk for heart disease, stroke, diabetes, and cancer, so it often happens that people in this category who experience heel pain will die at a younger age than those who are not in this category.

Conclusion

While plantar fasciitis and heel spurs are the most common issues behind discomfort in the foot there are many other causes of heel pain (but not Plantar Fasciitis), and being overweight is the most dangerous to your overall health.

If you find yourself suffering from heel pain then you need to examine your life and your habits to determine what the most significant contributing causes are to your condition, and then you need to take the steps to remedy the problem before it become chronic or even more damaging to your health and well-being.

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