As we enter springtime, we will do more activities on our feet than we tend to do over winter. This can bring on foot problems for us, one of which is heel pain. But did you know that:
(*click on each of the headings to be taken to a video about it*)
Approximately 1 in 10 people will develop heel pain at some point in their lives. That’s a lot of people who are unable to walk or carry out their preferred activities without feeling some form of pain from one or both of their heels.
This sounds like a strange fact, but it needs to be said. In general, those with chronic long-term pain tend to put up with it and don’t share it with others. To external eyes, the person may not portray they are in pain, when inside their heel is shouting “PAIN”. This can affect their mood, their outlook, and their general health & wellbeing
Both of these are true. In some people, heel pain is easy to fix especially if the cause is obvious and dealt with promptly. In others, it can be challenging for even doctors, physiotherapists, and other health care professionals to fix. Fortunately there is help available (see point 14 below).
The term “heel pain” is not a diagnosis. It is a descriptive term that does not provide a specific diagnosis or reason for it being there. There have been over 40 possible diagnoses identified, hence treatments can vary. Note that what treats one diagnosis could be harmful to another diagnosis.
In nearly all cases of heel pain, the only thing that might show up on X-ray is a bone spur and research has shown us that this is not the predominant cause of the pain. Focussing on the results of an X-ray can actually lead to incorrect or ineffective treatments.
Whilst plantar fasciitis can present as pain under the heel, in some cases the pain from that condition can be further along the sole of the foot as the plantar fascia runs from the heel bone (calcaneum) to the ball of the foot (the metatarso-phalangeal joints). Plantar fasciitis is just one of the possible specific diagnoses for heel pain.
If there is pain at the back of the heel yet still located on the heel bone, then it could be what is known as “insertional Achilles tendonitis” as this is where the tendon inserts into the bone. Treatment of this specific condition needs careful guidance from someone who knows how to help as it is often difficult to resolve.
Conditions such as lumbago, sciatica, or systemic issues can cause heel pain without there being anything wrong with the heel. That’s why indepth assessment should always be carried out for non-resolving heel pain.
It can do yes, but the right exercises at the right time is what really matters. Also for some diagnoses, exercise treatment can make heel pain worse. Load management is key to the resolution of the most common presentations of heel pain.
Again, it can do, but the correct heel pad / insole / orthotic / footwear prescription & “dosage” of device is important to achieve resolution. The wrong device or wrong materials can make matters worse not better. Also, just because one device costs more than another, does not mean it is any better than the cheaper device.
As difficult as that may be to believe or understand, we know that pain is an output from our brains. It is affected by many things including our childhood experiences of pain management, our stress levels, and other things that may be affecting our bodies. This all comes under the biopsychosocial model of pain, and understanding that can really help to beat heel pain.
In some cases, steroid injections are indicated but these are more commonly used by GPs & Surgeons who may not be as many other treatment options available to them. The injections don’t have to be painful, but it is all down to the person who is doing the injecting.
Yes, but not all Podiatrists treat heel pain. There are many good Podiatrists who can provide indepth assessment, accurate diagnosis, and effective individualised treatment plans, especially those with plenty of tools in their toolbox to help.
To watch a video of all these must know facts, then here it is on our YouTube channel.
At Health First Foot & Gait Clinic we have been treating heel pain for over 20 years and have the widest selection of treatment tools available – including advanced therapies such as shockwave and high-intensity laser therapy. Don’t delay – call us today on 01926 811272 or book online to get the help you need. Remember #PodsHealHeels and #PodsFixFeet.