What is Heel Pain?

Heel pain describes pain felt at the bottom or behind the heel of the foot. This pain can be felt directly through trauma or gradually appear over time. Many conditions and injuries can cause a sore heel(s). This article will discuss how GPs can help you manage and overcome your painful heels. According to the Australian Family Physician, around 3.6% of the Australian population experiences heel pain [1]. As a result, this health problem affects more than 900,000 individuals each year. An Adelaide study found that age, obesity and female gender increase the chance of developing painful heel(s) [2]. Many structures in the heel region can cause pain, including bone, tendon, and a protective fat layer. As a result, there could be several different reasons why you may be experiencing sore heels. Having your foot checked out by a GP needs to get an idea about what could be causing your symptoms is essential.  

Heel Pain Symptoms

Symptoms of heel pain are generally consistent. They are typically areas of discomfort and pain that are located either below or behind the heel. However, depending on what condition or injury, you may experience different symptoms, including:

• Redness around the affected area
• Tender to touch
• Swelling
• Various triggers (e.g. heel pain when walking, sitting, bending over, etc.)

 

What Causes Heel Pain?

Causes of heel pain can vary from person to person, and there are many conditions and injuries of which heel pain can be a symptom. To help discover what could be the source of your symptoms, there are several factors to consider, including your past medical history, activity levels, aggravating activities and age. Examples of conditions that could be related to your heel pain includes:

• Achilles tendonitis or tendinopathy
• Bursitis
• Heel spurs
• Heel fat pad syndrome
• Diabetes (click here for more about types 2 diabetes)
• Stress fracture
• Fracture
• Arthritis
• Tarsal tunnel syndrome
• Radiculopathy
• Nerve pain

 

Tests and Diagnosis

Always visit a healthcare professional, such as a GP, to receive a formal diagnosis for your heel pain. They will ask you questions, perform a physical examination or/and request testing to determine the presence of any heel injuries and/or conditions. Examples of tests that your GP may recommend for your heel pain include:

Imaging

Depending on the suspected reason for your symptoms, your GP may recommend imaging investigations of the foot, ankle and/or heel. A variety of tests, such as X-rays, ultrasounds, MRIs and CT scans, can be used to create images of the heel and foot. They will be able to pick up any abnormal structures in these areas to determine the source of the pain. Read more about imaging tests by clicking here.

Physical Examination

A physical examination of the foot may be necessary to gather more information. Observations, such as the quality of the skin over the heel, your foot posture, swelling and walking patterns, may explain why you’re experiencing discomfort. Your GP may also refer you to other healthcare professionals, such as a podiatrist or physiotherapist may also help with your diagnosis.

Blood Tests

Sometimes, underlying medical reasons can be responsible for an increased risk of developing heel pain conditions [3]. Blood tests are performed when a sample of your blood is drawn and taken for laboratory analysis. Certain markers in your blood may suggest the presence of a relevant condition (e.g. diabetes, inflammatory arthritis, etc.).
 

Heel Pain Treatments

Treatment for heel pain will depend on the cause of your symptoms and diagnosis. Given the many conditions that can cause heel pain, management and treatment plans should be personalised to your set of circumstances.

Pain Medications

GPs may prescribe medications, such as anti-inflammatory and pain relief drugs, to ease your symptoms and discomfort. If you have reactions to certain medications, let your GP know beforehand. Always take your medications as guided by your doctor.

Podiatrist

If your GP suspects that your heel pain is related to a physical issue, they may refer you to a podiatrist. These are health professionals specifically trained to manage any foot and/or ankle problems. They have a range of treatments that may help relieve and fix your heel pain, including:

• Footwear recommendations
• General or custom orthotics
• Advice about foot posture
• Taping
• Education and strategies for heel pain management
• Encourage ankle and heel support (e.g. braces, boots, etc.)

Physiotherapist

A referral to a physiotherapist can also be made to address impairments related to your heel pain. Physiotherapists are healthcare professionals who manage and prevent pain around the body (including the foot, heel and ankle). They encourage active treatments to help you overcome your heel pain, including:

• Specific heel pain exercises and stretches
• Taping
• Dry needling
• Manual therapy for pain relief
• Electrotherapy for pain relief
• Education and strategies
• Post-operative rehabilitation and management (if your heels needed surgery)
• Encourage ankle and heel support (e.g. braces, boots, etc.)

Shockwave Therapy

Shockwave therapy uses a machine to deliver invisible shockwaves through the foot and heel. This non-operative treatment is used to help increase blood flow and reduce the sensitivity of the affected area [4]. It is typically used for persistent plantar fasciitis pain that does not respond to other treatments. However, it may not be suitable for all types of heel pain.

Podiatric and Orthopaedic Specialist

For painful heels that are either severe or fail to respond to other forms of treatment, your GP may refer you to a podiatric or orthopaedic specialist. They are specially trained podiatrists and/or doctors that deliver more elaborate treatment, such as surgery and/or injections. More invasive treatments should only be considered a last resort if other treatments are not an option or fail to help.
 

Recovery

Recovery from heel pain will vary depending on the related cause and/or condition. The earlier you talk to your GP about your heel pain, the more likely you will receive immediate testing and treatment. This is more likely to lead to a faster and more successful recovery.
 

Complications

Complications of heel pain will vary depending on the condition of your heel and general health. Painful heels can affect your ability to perform weight-bearing movements, such as jumping, hopping, walking and even standing. As a result, many people with heel injuries or problems will find that exercise, work, or even essential daily tasks can become challenging. If not managed appropriately or early, it can affect your ability to participate in social and recreational activities.
 
 

Receiving quality care from highly experienced doctors is essential for a prompt diagnosis and receiving the correct medical treatment. With 24-7 MedCare, you can experience telemedicine from the convenience of your own home. Our friendly online doctors will be available 24/7 for a consultation, anytime and anywhere in Australia.

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References

1. Pollack, A., & Britt, H. (2015). Plantar fasciitis in Australian general practice. Australian family physician, 44(3), 90-91.
2. Hill, C. L., Gill, T. K., Menz, H. B., & Taylor, A. W. (2008). Prevalence and correlates of foot pain in a population-based study: the North West Adelaide health study. Journal of foot and ankle research, 1(1), 1-7.
3. Rio, E., Mayes, S., & Cook, J. (2015). Heel pain: a practical approach. Australian Family Physician, 44(3), 96-101.
4. Jessup, R. L., Oates, M. J., Johnston, R. V., & Buchbinder, R. (2019). Shockwave therapy for plantar heel pain (plantar fasciitis). The Cochrane Database of Systematic Reviews, 2019(11).