If you’ve ever suffered from heel pain, you know just how debilitating it can be. Whatever the cause, heel pain can prevent you from staying active, enjoying sports and outdoor activities, and even impact your everyday life and ability to work.
While plantar fasciitis is the most common and most well-known heel problem our patients experience, if you’re experiencing heel pain, there may be other causes as well. A proper diagnosis is important for successful treatment.
1. Bursitis
Bursitis of the heel occurs when the retrocalcaneal bursa becomes inflamed and irritated. The retrocalcaneal bursa is the cushion for your heel, and if you have bursitis you’ll feel pain at the back of the heel where it meets the Achilles tendon. Your skin may also be red and tender above this area. Bursitis treatment is similar to plantar fasciitis treatment, with rest and ice being the first options. Orthotics are a second treatment option as they protect the heel from impact with the ground when walking.
2. Achilles Enthesitis
Achilles enthesitis occurs when you experience pain where the tendon attaches to the heel bone. Both achilles tendonitis and enthesitis are common causes of heel pain, and can become a lingering issue. This is because the tendon gets very little blood supply, causing injuries to take longer to heal.
3. Haglund’s Deformity
If you wear high heels regularly, you may develop heel pain known as “pump bump,” but the medical term for this kind of heel pain is Haglund’s deformity. With this kind of heel pain, your heel bone will become enlarged as the result of your Achilles tendon being caught between the heel bone and the back of your shoe. You may experience redness and swelling as well. Anti-inflammatory medications, icing and proper footwear are usually effective treatments for Haglund’s deformity, while orthotics are also a great way to reduce your symptoms.
4. Tarsal Tunnel Syndrome
Tarsal tunnel syndrome causes pain in the foot where the tibial nerve becomes compressed as it travels through the tarsal tunnel. It’s also known as posterior tibial neuralgia. One branch of the nerve continues directly to the heel. Entrapment of this particular nerve can lead to pain that almost exactly mimics the pain associated with plantar fasciitis. The one main difference is when the pain occurs. Plantar fasciitis typically occurs immediately following rest, while tarsal tunnel syndrome will hurt with increased activity.
5. Fat Pad Syndrome
Fat pad syndrome is caused by decreased elasticity of the fat pad. Sometimes, it can be related to a fall or a direct blow to the heel. It can also be due to excessive force on the heel due to poor footwear. As compared to plantar fasciitis, heel pain related to fat pad syndrome will tend to be found more so on the middle or outside of the heel (as opposed to the inner aspect of the heel in plantar fasciitis).
Each one of these five conditions requires very different management solutions and it’s therefore critical that the right diagnosis be made. At Walking Mobility Clinics across Ontario, we treat a wide range of foot pain. If you’re still not sure what may be causing your pain, take a look at some of these common causes of foot pain.