Heel pain is a common problem nowadays. Most heel pain comes under the heel, behind the heel and at the sides of the heel. It starts gradually with no history of injury. The common cause of pain is uncomfortable shoes. The other may include arthritis, infection and trauma. The heel is a specialized part of the body which absorb the body weight while locomotion. When pain occurs, it becomes difficult to walk even few steps.
- Causes of Heel Pain:
- Home Remedies for Heel Pain:
- How to Cure Heel Pain – Conservative Treatment:
Causes of Heel Pain:
1. Plantar Fasciitis:
This is a common heel problem. Pain occurs under the ball of the heel, or slightly forward of this. The main complaint is keeping the first step in the morning after you wake up, but the pain is regular on weight bearing throughout the day. Plantar fascia is a bowstring that supports the arch in the foot. It acts as shock absorber. Several factors increase the risk of plantar fasciitis. These are,
Age: common between the age of 40- 60 years. Nowadays it occurs even at young age due to improper and uncomfortable footwear.
Obesity: Obese people are more prone to the plantar fasciitis. It stresses the fascia and causes pain.
Occupation: Those people who have prolonged standing jobs like teachers, factory workers and guards are more prone to plantar fasciitis. This creates excessive pressure on the fascia due to prolonged standing on hard surfaces.
Foot Alignment: High arch or flat foot creates abnormal pressure on the fascia due to the disturbed walking pattern.
High Stress Activities: Certain exercises like long distance running, aerobic dance and so on contribute to the early onset of plantar fasciitis.
2. Calcaneal Bone Lesions:
Any bony disorder in calcaneum ( heel bone ) like stress fracture, osteomyelitis, osteoma causes heel pain.
3. Calcaneal Bursitis :
This is also common as heel bursitis. There is a bursa (fluid filled sac) at the back of the heel. Inflammation in the bursa causes pain at the back of the heel. This occurs due to shoe friction or landing in the wrong position. Pain increases in cold weather and after wearing tight fitting shoes from the back or high-heeled shoes.
4. Sever’s Disease:
It usually affects young boys of the age group of about 10 years. There is pain and tenderness at tendo Achilles insertion. It is caused by repetitive trauma and overuse of growth plates of the heel bone.
4. Painful Fat Pad:
The fat pad under the heel protects the heel from daily shocks and trauma. Sometimes this heel pad becomes the reason of pain. There is inflammation of fat pad due to repeated and prolonged activity. Sometimes it occurs due to direct blow to the area like fall from the height or landing directly on the heel from the height or from the force. It also occurs in athletes where there is activity like jumping and running. In certain conditions, there is displacement of fat pad from the bone. This causes loss of shock absorbing effect causes excessive pain. It becomes difficult in walking barefoot.
5. Heel Spur:
It is a calcium deposit causing bony protrusion on the underside of the heel bone. They can cause heel pain but at times are painless. They are often associated with plantar fasciitis. It is a long duration process and normally occurs due to repetitive strains on muscles and ligaments or tearing of membrane covering heel bone.
6. Other Causes:
Some other causes like gout, rheumatoid arthritis, Achilles tendon rupture and poor posture while walking or jogging.
Home Remedies for Heel Pain:
1. Contrast Bath:
Take 2 buckets. Fill one with hot water. Hot should be at the comfortable level. Fill another bucket with cold water. Put some ice in it. Immerse the feet in a hot bucket for 3 minutes and then immediately dip in cold bucket for 1 minute. Repeat for 15 minutes two times daily.
2. Ball Massage:
Take a tennis ball and keep it under the heel. Try to roll the ball. While rolling, press the heel of the foot to ball of the foot till the base of the thumb over the ball. This helps to release the fascia. Put extra pressure over the ball of the heel. This helps to release the pressure.
3. Bottle Rolling:
Take a freezing water bottle. Keep it under the foot. Roll the affected area over it. Continue this for 15 minutes twice a day.
4. Hot Fomentation:
Soak the foot in hot water. Put some Epsom salt in it. It helps to relax the muscles and the fascia.
5. Foot Massage:
Try to apply pressure on the entire heel with the help of thumb or knuckles. Extend to the ball of the foot till the base of the thumb. This helps to relax the fascia.
- Foot Packs: Soak a cloth in hot linseed oil and wrap the feet in the cloth.
- Try to walk on the toes after getting up from the bed early morning. It helps to release inflammation in the fascia.
- Walking on the outer side of the foot with fingers curl helps to strengthen the arch of the foot.
6. Self Stretching Techniques:
a. Calf Muscle Stretch:
In long sitting position- wrap a towel around the arch of the feet. Hold the edge of the towel with the hand. Try to pull the feet towards the face. Hold for 15 seconds and repeat 5 times.
Stand on the base of the toes on the edge of the staircase. Try to lower the heel of the affected limb until you feel a stretch. Keep the knees straight. Hold for 30 seconds and relax. Repeat 10 times.
b. Plantar Fascia Stretch:
Sit on the floor with knees bent and toes bending upwards. Lower your buttocks so that you feel the stretch at the arch of the foot. Hold for 30 seconds and repeat 10 times.
Sit on a chair with the affected foot on other knees. Try to pull the toes upwards with your hand. Hold for 30 seconds and repeat 10 times.
Try to stand on the toes. Maintain the position for 30 seconds and repeat 10 times a day.
c. Strengthening Exercise:
Keep a towel on the floor. Put some weight in the form of pebbles on the towel. Try to curl the towel with the toes.
Tie a rubber band around the toes. Spread the toes against the resistance of the band. Hold for 10 seconds and repeat 10 times.
Try to pick a pebble with the toes and place it in the bowl. Take 10 pebbles at a time.
Night splints – certain night splints help to stretch the Achilles tendon and helps in relieving pain.
7. Heel Insoles:
it is important to do shoe ware modification. Use soft comfortable shoes. Do not wear slippers having hard soles. For external support use silicon based insoles. Take full-length insoles. This helps to avoid pressure on the base of the toes. Insoles that cover only heels may cause pressure at the bottom of the toes causing problems like metatarsalgia.
8. Medial Arch Support:
Use medial arch to compensate the flat foot. This helps to correct the flat foot. This releases the pressure from the foot and may help in heel pain.
9. Shoe Modification:
Wedge placement- relieve strain from the fascia by providing an appropriate wedge in the shoes. This relaxes the fascia. This is done by adjusting the height of the heel to the minimum level at which the pain disappeared. You need to consult a physiotherapist to check the alignment of the foot. They will guide you about the wedge placement.
Avoid shoe heels. This creates extra tightness in Achilles tendon further increasing plantar fasciitis.
Use shock absorbing heel cups in case of the painful fat pad.
calcaneal spur- wear open back shoes. This helps to reduce irritation caused by the spur.
How to Cure Heel Pain – Conservative Treatment:
One should consult an orthopedician for heel pain. Few medications can be helpful in reducing the pain-
- Non- steroidal anti-inflammatory drugs (NSAIDs) – these include ibuprofen, naproxen and ketoprofen.
- If NSAIDs does not work, then corticosteroid injections are injected. These should be the last option as they can have adverse effects.
- Acetaminophen- this helps in relieving pain.
It is important to take rest to decrease the inflammation. You need to stop activities like running, jogging and direct landing on heels.
Vitamins and minerals may help to improve the health of the feet. Certain elements are,
a. Calcium: The adequate amount of calcium may help in decreasing the formation of bony spurs. Some of the calcium-rich foods are-
b. Magnesium: Magnesium is important to absorb calcium from the blood. Magnesium is important to manage calcium. Some food items rich in magnesium are-
c. Vitamin D: There is a growing deficiency of vitamin d these days due to poor exposure to sunlight. This is because of growing sedentary lifestyle. Vitamin d should be incorporated into your diet daily. This include-
d. Bioflavonoid: These are at times refer to as vitamin P. These are super antioxidants. Natural source of bioflavonoid are,
Vitamin C rich food like- citrus fruits like oranges, lemon and peaches.
Berries- berries like strawberry, blueberry
e. Anti-inflammatory Diet: It fights against inflammation caused due to heel spurs or other causes of heel pain. Some anti-inflammatory rich food is,
4. Physiotherapy Management:
Physiotherapy management is an important treatment for heel pain. One should always go and consult the physiotherapist for heel pain.
Physiotherapy modalities like ultrasound, wax bath laser therapy, faradic foot bath and TENS helps to relieve pain.
Apply cold packs in case of swelling.
Massage Therapy: Massage procedures like kneading, vibrations and knuckle kneading helps to release the tight fascia and helps in pain relief.
Stretching: Stretching of the calf muscle and plantar fascia helps to release the pain.
Strengthening Exercises: Strengthening of intrinsic muscles helps to release the problem.
Heel pain is a common problem. Various reasons like improper footwear, faulty foot alignment, high-stress activities like jogging and running, plantar fasciitis, calcaneal spurs and painful fat pad cause heel pain. There is pain, inflammation, swelling and tenderness on the heel. There are various exercises to release heel pain. This includes stretching of the calf muscle and plantar fascia. Strengthening of intrinsic muscles helps to release heel pain. Certain diet modifications can help to release pain like an anti-inflammatory diet, a diet rich in calcium and magnesium. Various insoles and night splints can help to release the heel pain. Go for contrast bath treatment. Consult a proper orthopedician and physiotherapist for proper treatment.