Heel Pain

What causes heel pain? 

The most common causes of heel pain are actually quite typical injuries—Achilles tendonitis and plantar fasciitis. However, numerous injuries and conditions can also lead to heel pain. Some of these include:

Achilles tendon

The Achilles tendon is a band of tissue that runs along the back of the ankle and connects the calf muscle to the heel bone (calcaneus). Overuse and injury can lead to Achilles tendinitis (inflammation of the tendon) or an Achilles tendon tear. 

Due to its location and connection to the heel bone, an overuse injury to the Achilles tendon can lead to heel pain. Conservative treatments include physical therapy to strengthen the tendon, rest, and over-the-counter medications to reduce inflammation.

Arthritis

Psoriatic arthritis, reactive arthritis, and rheumatoid arthritis can all lead to joint pain. Psoriatic arthritis—arthritis linked to psoriasis—can particularly cause pain at the sites where ligaments connect to bones, such as where the Achilles tendon attaches to the heel. 

Rheumatoid arthritis is an inflammatory condition that affects the lining of your joints. 

Fortunately, there are several treatment options available to lessen the effects of these types of arthritis and alleviate patients’ pain.

Bone spurs

Heel spurs, also called calcaneal spurs, are bony growths on the heel bone that develop due to prolonged pressure, friction, or stress on the heel. While bone spurs typically do not cause foot pain, the pressure or friction they exert on the surrounding soft tissue can lead to inflammation or discomfort.

Anti-inflammatory medications such as ibuprofen can alleviate the pain caused by bone spurs by diminishing soft tissue inflammation.

Calcaneal nerve entrapment

The nerve in your heel can become trapped in the arch of your foot, leading to pain in the ankle, heel, and arch. Many patients visit Dr. Bob after being misdiagnosed with plantar fasciitis, only to find out that the real cause of their pain is nerve entrapment.

Ice and rest help the nerve heal, while physical therapy can strengthen the tendons surrounding the nerve. In severe cases, surgery may be performed to release the trapped nerve and alleviate your pain.

Haglund’s deformity

Sometimes called a “pump bump,” Haglund’s deformity is an enlarged bony protrusion at the back of the heel. Wearing high heels and shoes with tight backs can cause irritation and pain in that area. If left untreated, irritation from Haglund’s deformity can lead to Achilles tendinitis or heel bursitis.

Heel cups, orthotics, or properly fitted shoes are all treatment options to relieve pain from Haglund’s deformity. It is extremely rare for this condition to require surgical correction.

Heel bursitis

Bursae are small, fluid-filled sacs that cushion and protect your bones. Each foot has a bursa located between the heel bone and the Achilles tendon. Retrocalcaneal bursitis refers to the irritation of the ankle bursa that leads to heel pain. 

Osteomyelitis

While not very common, bone infections (osteomyelitis) can also lead to heel pain. This condition typically arises in patients with chronic health issues such as diabetes. 

Treatment involves antibiotics, and severe cases may necessitate full or partial amputation. Preventing osteomyelitis is much easier through regular foot examinations. Identifying minor foot injuries before they lead to infection can help stop infection from spreading to your bones.

Plantar fasciitis

Perhaps the most common cause of heel pain, plantar fasciitis refers to the inflammation of the plantar fascia—the ligament that extends along the arch of the foot. Heel pain associated with plantar fasciitis is characterized by a stabbing sensation in the bottom of the heel. Patients with this condition often report that their heels hurt in the morning or after a long period of inactivity. 

Plantar fasciitis is a common foot issue for individuals with flat feet, as the ligament undergoes overstretching. Supportive shoes or arch support inserts are often adequate to alleviate plantar fascia pain during its early stages.

Plantar warts

Plantar warts are caused by HPV entering through tiny cuts or abrasions on your feet; they commonly occur in areas that bear weight—such as the heel. They can be painful when you walk or stand, which may cause you to alter your gait or posture, resulting in additional discomfort in the ankles, feet, or legs. 

While plantar warts will go away eventually, Dr. Baravarian is able to treat them from the comfort of his office. He has multiple options for treating or removing plantar warts to relieve your heel pain.

Sever’s disease

This condition is a common cause of heel pain in active children aged 8 to 14. Despite its name, Sever’s disease is actually an injury to the growth plate at the back of the heel. Most children will outgrow the pain, but stretching exercises for the Achilles tendon can also provide relief.

Stress fractures

People who start an exercise routine too quickly or suddenly increase their activity level are at risk of stress fractures. Stress fractures are overuse injuries that create tiny cracks in the bone. Running or jumping on hard surfaces without proper footwear can also add extra stress on your heels, leading to stress fractures.

Tarsal tunnel syndrome

The tarsal tunnel is a passage made up of bones and ligaments in your ankle, and your tibial nerve runs through this tunnel. Tarsal tunnel syndrome is a compression of the tibial nerve that can cause pain, numbness, tingling, or weakness in the foot. 

Pain can be managed with ice, rest, and over-the-counter pain medication. Meanwhile, braces or splints can hold the foot in place and allow the nerve to heal.

Other non-foot-specific causes of heel pain include ankylosing spondylitis, Paget’s disease, and sarcoidosis. 

How does Dr. Baravarian diagnose heel pain? 

To effectively treat your heel pain, Dr. Baravarian must identify the underlying cause. Your consultation will start with a review of your medical history, inquiries about your present symptoms, and a physical examination of your feet and ankles. 

Dr. Baravarian’s offices also have access to imaging technology, including X-rays and MRIs. Through medical imaging, he can examine the bones and soft tissues of your heel to identify injuries and fractures and assess the condition of your tendons and ligaments. 

Once he’s gotten to the root cause of your pain, his team will work with you to develop a treatment and pain management plan.

Why is Dr. Baravarian the best choice for heel pain in the Los Angeles area? 

Dr. Baravarian is at the forefront of foot and ankle care and surgery. He offers a full range of care, including conservative treatments, a spectrum of diagnostic imaging, MRI and CT scanning services, and dedicated foot and ankle physical therapy.

Dr. Baravarian is a nationally recognized expert in the treatment and correction of overuse injuries and foot deformities that lead to heel pain. He is at the forefront of treatment and research and is committed to offering state-of-the-art surgical and non-surgical foot and ankle treatments. He regularly teaches his techniques to foot surgeons around the globe.

By offering a full range of workup, conservative, surgical, and recovery options, Dr. Bob is genuinely taking care of you in a state-of-the-art manner without requiring you to go from place to place.

To schedule a consultation, please call (855) 557-5400 or make an appointment now.

Dr. Bob Baravarian is conveniently located in Los Angeles, near Cedars-Sinai Medical Center, providing expert foot and ankle care for patients throughout Southern California.