Understanding the Heel Pain!

Heel pain can be really problematic when it is caused with standing or walking. It is true that foot and ankle, and heel pain are common problems seen in most individuals. The heel bone is the largest bone in the foot, absorbing most of the impact while we are walking, standing or running. So it is no wonder that we are so much prone to sore heels or heel pain when standing or walking. However, if you want to know about some of the causes that might be the reason behind heel pain when standing or walking, then you need to read through the following array of the article.

What Causes Heel Pain When Standing or Walking?

Pain is generally felt at the back side of the heel or underneath it and it can really affect your daily life. Though the heel pain settles down in a quick time, but even in prolonged cases, its causes are rarely very serious. Often, heel pain leads to secondary problems like trying to walk differently so as to try and reduce the pain. Below we will look at some of the most common causes of heel pain when standing or walking.

Top 10 Causes of Heel Pain When Standing or Walking Include:

  1. Plantar Fasciitis:

    A thick band of tissue present on the sole of the foot is known as plantar fascia. Damage to this is the most common reasons for heel pain and it affects 1 in 10 people. Overuse or being on your feet for long time, muscle weakness and tightness, obesity, altered foot biomechanics, etc. are some of the causes of Plantar fasciitis that may cause heel pain when standing or walking. With such a condition, there would be pain and tenderness under the heel, which becomes worse after rest, when standing on tiptoes or even while going up stairs. Apart from this, there is often a specific spot which is particularly painful when it is being touched.

    There may be some associated problems like the formation of a heel bone spur. Rest, injections, exercises, orthotics, and also occasionally surgery are some of the treatment ways for heel pain caused due to plantar fasciitis.

  2. Achilles Tendonitis:

    Achilles tendonitis is the most common causes of all back of heel pain. Achilles tendon is that which connects the calf muscles to the heel bone. Inflammation or degeneration of this Achilles tendon is known as Achilles tendonitis which can also be a cause of heel pain when standing or walking.

    Repetitive strain on the tendon, generally from muscle weakness or muscle tightness, altered foot biomechanics or friction from heel bone spurs, results is Achilles tendonitis. There is a pain in the back of the heel, which gets worse after rest and in the morning after getting up from the bed, there is also ankle and calf stiffness with Achilles tendonitis. Swelling or tender lump in the tendon at the back of the heel or just above the ankle is also seen in Achilles tendonitis. There may be associated problems like calcaneal bursitis or inflammation of the fluid-filled sac present between help bone and the Achilles tendon.

    Rest, exercise, orthotics, Medications and injections can be used for treating the condition.

  3. Bone Spurs:

    Heel pain when standing or walking can also be a result of bone spurs. Calcaneal bone spurs can occur both, underneath and also at the back of the heel and may cause foot, ankle and heel pain. These are the bony lumps that stick out and are formed by excessive calcium deposits on the bone. Repetitive overuse, like jumping, running, standing long, muscle weakness and tightness, abnormal heel position, etc. can cause this condition.

    With this, there is pain in heel when first get up after resting long. This pain generally settles to a dull achy heel pain. Some individuals have no pain at all with heel bone spurs; however, bony lumps would be noticeable. Bone spurs are generally linked with plantar fasciitis and Achilles tendonitis. Stretching and strengthening exercises, orthotics and surgery are some of the treatment ways.

  4. Bursitis:

    Retrocalcaneal bursitis is one more cause for heel pain when standing or walking. It is the inflammation of a small fluid filled sac known as bursa that sits between the Achilles tendon and the heel bone. Repetitive friction on the bursa, generally caused by muscle tightness and muscle weakness or a sudden increase in activity levels can lead to bursitis.

    Symptoms here may include the back of heel pain, especially when standing or walking or running on tiptoes. Swelling, redness and warmth at the back of the heel may also be felt. Achilles tendonitis is the commonly associated problem of retrocalcaneal bursitis.

    Rest, ice, medication, injections and calf exercises can treat the condition and the heel pain associated with it.

  5. Heel Fracture:

    Single or multiple cracks or breaks in the heel bone may cause heel pain when standing or walking. Repetitive overloading of the heel, like; in case of jumping, running, etc can cause stress fractures leading to the heel fracture or a fall from a height lading feet first may also result in heel fracture.

    There may be pain that get worse by pressure through the heel and also swelling may be present in fractured heel. This fractured heel may also cause you to walk differently.

    Stress heel fractures are usually treated with medication, PRICE or Protect, Rest, Ice, Compression and Elevation. However, in case of severe heel fractures, surgery may be required.

  6. OS Trigonum Syndrome:

    Heel pain when standing or walking may also be caused because of another condition known as OS Trigonum Syndrome. This is one of the rare causes of heel pain and tends to affect most ballet dancers and athletes. This is actually the irritation of the soft tissues present at the back of the heel.

    A small extra bone, called as OS Trigonum, gets struck in the ankle joint and irritates the soft tissues surrounding it. This is normally caused by repeated plantar flexion or foot pointing downwards or because of an ankle injury.

    Generally, there is a deep and dull pain at the back of the heel.

    Rest, ice, steroid injection are some of the common treatment ways for treating such a condition leading to heel pain when standing or walking. In some cases, surgery might also be required.

  7. Sever’s Disease:

    Sever’s disease is one of the most common cause for heel pain in children. This is an inflammation of the growth plate of the heel. It is caused by the growth spurt where the heel bone grows faster than its surrounding muscles and ligaments, which occurs because of standing for long, overuse from participating in lots of sporting activities such as jumping or running, etc.

    There is pain in heel, especially at the back or underneath the heel, when standing or walking. Inflammation and tenderness, pain when walking, stiffness of ankle etc, are some other symptoms of Sever’s disease. Symptoms become worse with physical activities and they improve with rest. This condition usually affects both feet at the same time.

    Strengthening and Stretching exercises, orthotics, rest, medications are some of the treatment methods for this condition. It must be mentioned that the symptoms of heel pain generally settle within couple of months.

  8. Tarsal Tunnel Syndrome:

    There is one more condition that can cause heel pain when standing or walking. Tarsal tunnel syndrome is the compression of the tibial nerve as it passes through the tarsal tunnel on the ankle’s inner side. This is caused by anything reducing the space in the tarsal tunnel, like swelling, ganglions, arthritis, cysts, benign tumors or flat feet. Foot heel pain which can spread up the calf is one of the most common symptoms here. Along with heel pain when standing or walking, there may also be numbness, hot and cold feeling in the foot etc. The symptoms here get worse at night. It generally affects only one foot.

    Rest, exercises, anti-inflammatory medication, shoe orthotics, steroid injections, etc. along with surgery are some of the ways to treat tarsal tunnel syndrome causing heel pain when standing or walking.

  9. Arthritis:

    Arthritis is a disease which causes inflammation of the joint, and may strike your feet. In such condition, you may feel heel pain when standing or walking. In case you have flat feet then you may be at a higher risk of getting arthritis. Although, it generally affects bones in the middle of the foot, arthritis can sometimes also affect the joint connecting the heel bone and you may develop a condition called post-traumatic arthritis in your feet in case you ever had an ankle injury. This would cause the heel pain, especially as you walk or stand for long hours.

    Rest and anti-inflammatory medications usually offer relief in such conditions. You must consult your doctor who may suggest appropriate shoe insert so as to help stabilize your foot.

  10. Fat Pad Atrophy:

    The natural cushioning eventually wears down slowly and gradually as our feet step more than 100,000 miles over the course of a lifetime. Thinner fat pads increase the pressure on the heel, which is second most common cause of heel pain.

    Rest, ice and anti-inflammatory medicines can get you temporary relief, but providing the right support can prevent it altogether. You need to skip the high heels or flats, and look for a pair of supportive shoes. You may also require wearing a heel lift, as these inserts transfer some of your weight to the front of your foot and thus relieve pressure on your heel. In case you have such a condition which is causing heel pain when standing or walking, then do avoid walking pavement and try walking on a soft surface like grass or a track, also avoid high-impact activities such as jumping.

Conclusion:

Most causes of heel pain are not serious and they get settle down with a combination of appropriate rest and strengthening and stretching exercises. However, it is always essential for you to get an accurate diagnosis and treatment, which requires you to consult your doctor.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: November 16, 2017

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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