Understanding Heel Pain: Causes and Solutions
Heel pain at the back of the foot is common and caused by conditions like Achilles tendinitis, bursitis, or Haglund’s deformity. Treatment involves medications, physiotherapy, lifestyle changes, and in severe cases, surgery. Proper diagnosis is essential for effective relief and prevention of further complications.
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Signs include swelling, tenderness, redness, and pain, which intensify with activity and prolonged standing.
Heel pain at the back is not a standalone diagnosis but a symptom of underlying issues like plantar bursitis or Achilles tendinitis. Treatment focuses on identifying these causes and alleviating symptoms via medications, physiotherapy, and home care.
Main Causes of Heel Pain
Since heel pain symptoms can be vague, proper diagnosis is essential. The three primary causes, known as the 'terrible triad,' include insertional Achilles tendinitis, retrocalcaneal bursitis, and Haglund’s deformity.
Insertional Achilles Tendinitis
This condition involves the Achilles tendon — a vital, strong tissue connecting calf muscles to the heel, enduring up to 24 times body weight during activity. Repetitive stress, especially in athletes, causes degeneration, inflammation, swelling, and redness at the tendon’s insertion point on the heel bone (calcaneus). Chronic issues may lead to calcification with bone-like deposits.
Retrocalcaneal Bursitis
Bursae are fluid-filled sacs aiding smooth tissue movement. In the heel, bursae help the Achilles tendon glide. Inflammation, called bursitis, causes swelling, and in severe cases, a visible bump. Contributing factors include heel bone thickening or Achilles tendon thickening.
Haglund’s Deformity
This bony bump forms on the back of the heel, often caused by friction from hard shoes like dress shoes or heels. The soft tissue around the area becomes inflamed, leading to pain and irritation.
Additional causes include:
Tarsal Tunnel Syndrome
Plantar Fasciitis
Peripheral Neuropathy
Stress Fractures
Treatments for heel pain aim to relieve symptoms and address root causes. Options include heel lifts, stretching exercises, NSAIDs, weight management, and surgery if necessary. Lifestyle modifications like proper footwear and foot support also help prevent recurrent issues. Consulting a healthcare provider ensures accurate diagnosis and effective treatment.
