Heel pain is the most common problem I treat.
There are two distinct places where heel pain occurs, on the bottom of the heel or in the back of the heel.
Heel pain can be brought on by an injury, but most often the cause is a long standing, low grade tension that left untreated will eventually cause pain and inflammation.
Plantar fasciitis or Heel spur syndrome
Causes pain under the heel due to tension on the plantar fascia as it courses from the bottom of the heel to the base of each toe.
It is most common in people with a flatfoot type.
Long standing tension on the insertion of the plantar fascia on the heel bone can cause reactive growth of bone resulting in a spur.
It is not the spur that hurts, but the inflammation around the insertion.
Causes pain on the back of the heel or ankle and can also present with or without a bone spur.
The Achilles’ tendonitis is often caused by a tight Achilles’ tendon that limits motion at the ankle joint causing tension at its insertion on the heel bone.
This tension also causes reactive growth of bone in the form of a spur.
Sometimes, however, a large bump on the back of the heel is not caused by a spur, but the shape of the heel bone.
Is a bony prominence on the back of the heel, usually lateral to the insertion of the Achilles’ tendon, but not always. It is also known in women as a “pump bump”.
It is distinguished from an Achilles’ heel spur on an x-ray because it is not visible due to its lateral orientation and posterior Achilles’ heel spurs are always visible.
Calcaneal Stress Fracture
A lesser known cause of heel pain. The Calcaneus, or heel bone, is a large bone that is not easy to injure, but hairline (or stress) fractures can occur due to overuse.
This is seen in athletes and non-athletes alike and is caused by a low-grade repetitive trauma that eventually weakens the bone causing it to crack.