Heel Pain & Plantar Fasciitis
Plantar fasciitis is an inflammation of the ligament running from your heel to the ball of your foot, which is called the plantar fascia. The bottom, or inside, of your heel may hurt when you stand. The pain usually decreases after you walk a few steps, but it may return with prolonged movement. Plantar fasciitis can occur in patients whose foot flattens too much, or whose foot doesn’t flatten enough.
An additional source of heel pain can be tendinitis around the ankle, which is an inflammation of the tendon or tissue, that surround it. This is called tendinitis. You may feel pain when you move your ankle or when your heel shifts from side-to-side. The Achilles and peroneal tendons are common sites for this problem.
A heel spur is a bony outgrowth at the base of the heel bone near the plantar fascia. A spur may cause pain on the bottom of the heel when you stand. As with plantar fasciitis, the pain may decrease after standing or walking a short time. The pain you feel is not from the spur itself. Your heel hurts because the inflammation from the irritation of the plantar fascia, near the spur is irritating a nerve or pressing against a plantar bursa. If the bursa becomes inflamed, a secondary bursitis can also develop.
A source of heel pain in children is called Sever’s disease, or calcaneal apophysitis. This is an inflammation of the area between the sections of the bone that make up the heel. It occurs in young people whose bones have not yet fused and matured. The back of the heel may hurt on walking, forcing the patient to limp.
Haglund’s deformity or bony outgrowth on the upper part of the back of the heel may cause pain and irritation with shoes. Rubbing the back of the bone against the Achilles tendon causes redness and irritation.
A final possible source of heel pain is a stress fracture. A stress fracture is a crack in the heel bone, usually behind or below the subtalar joint, which is the last bone of the foot beneath the ankle. You may feel pain during extended activity and when you touch the area.
