Heel Pain

A common indicator* of heel pain is the heel spur, a bony growth on the bottom of the heel bone. The spur, visable by X-ray, appears as a protrusion that can extend forward as much as half an inch. When there is no indication of bone enlargement, the condition is sometimes referred to as "heel spur syndrome."

Heel spurs result from strain on the muscles of the foot, by stretching of the long band of tissue that connects the heel and the ball of the foot, and by repeated tearing away of the lining or membrane that covers the heel bone. These conditions may result from biomechanical imbalance, running or jogging, improperly fitted or excessively worn shoes, or obesity. 

*While the spur itself usually does not cause pain, it is a good indicator of Plantar Fasciitis (see below).

Both heel pain and heel spurs are frequently associated with an inflammation of the band of fibrous connective tissue (fascia) running along the bottom (plantar surface) of the foot, from the heel to the ball of the foot. The inflammation is called plantar fasciitis. It is common among athletes who run and jump a lot, and can be quite painful. This is the most common cause of heel pain, even in non-athletes.

The condition occurs when the plantar fascia flattens out and elongates over time beyond its normal extension, causing the soft tissue fibers of the fascia to tear at the heel bone. A gap occurs between the fascia and the heel bone, which may be filled in with the growth of new bone.

The inflammation may be aggravated by shoes that lack appropriate support, especially in the arch area, and by the chronic irritation that sometimes accompanies an athletic lifestyle.



• If pain and other symptoms of inflammation - redness, swelling, heat - persist, you should limit normal daily activities and contact a doctor of podiatric medicine.

• Your podiatrist may perform various diagnostic X-rays to rule out heel spurs or fractures. Early treatment might involve oral or injectible anti-inflammatory medication, stretching, exercise, and shoe recommendations, taping or strapping, or use of various shoe inserts or custom orthotic devices.

• Taping or strapping supports the foot, placing stressed muscles in a physiologically restful state and preventing stretching of the plantar fascia. Physical therapy may be used in conjunction with such treatments.

• Functional Orthotics  may be prescribed for correcting biomechanical imbalance, supporting the heel, controlling excessive pronation and stretching of the plantar fascia. It will effectively treat the majority of heel and arch pain without the need for surgery.  Surgery for plantar fasciitis is rarely required if you maintain strict adherence to the conservative treatment recommendations provided by your podiatrist and physical therapist.