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heel pain

Alternative Names
heel spur syndrome, plantar fasciitis, heel bursitis, Achilles tendinitis, retrocalcaneal bursitis, heel stress fracture, calcaneal periostitis

What are the signs and symptoms of the condition?
The main symptoms are discomfort and pain in the heel. These symptoms become acute when the person goes about his or her daily routine, especially if exercise is involved.

What are the causes and risks of the condition?
There can be many causes for this condition. They include:
  • plantar fasciitis, which is an inflammation of the sole of the foot
  • a bruise from hitting the heel against a hard object
  • Achilles tendinitis, which is an inflammation of the Achilles tendon that runs down the back of the heel
  • inflammatory bursitis, which is a condition caused by the tendon rubbing on the back of a shoe
  • a misshapen heel bone
  • medial calcaneal neuroma, a condition in which the nerve on the inside and bottom of the heel becomes irritated and enlarged
  • gout, which is a disease that causes painful joints
  • rheumatoid arthritis, a severe form of arthritis that causes pain, swelling, inflammation, and, sometimes, destruction of the joints
  • inflammatory bowel disease, which is an inflammation of the large or small intestines
  • Reiter's syndrome, a type of arthritis that causes pain, swelling and redness in the joints, especially where the spine meets the pelvis
Very rarely, cancer involving the bone can cause heel pain.

What can be done to prevent the condition?
To prevent this problem, avoid activities that can damage the heel. Also, choose footwear that is right for the activity being performed. For instance, it is helpful to wear a thick-soled boot when digging with a shovel or sturdy, supportive running shoes when jogging.

How is the condition diagnosed?
Sometimes people who know what is causing their pain and where it is coming from are able to diagnose their problem. But some conditions are not so obvious and will require medical help. Usually a doctor or specialist can quickly make the diagnosis with a simple examination. Sometimes, X-rays or special studies, such as bone scans, computerised tomography or CT scans, and magnetic resonance imaging or MRI, are used. If the problem involves inflammation, an evaluation for this condition, including a complete arthritis workup, may be necessary.

What are the long-term effects of the condition?
Most heel pain resolves quickly with treatment. But if the heel pain is an early sign of arthritis, it could eventually affect other parts of the body.

What are the treatments for the condition?
Treatment begins by protecting the affected area from further irritation. If there is inflammation, anti-inflammatory medications, an ice pack, and sometimes, physiotherapy can help. The careful selection of proper-fitting footwear is important.

Author: Bill O'Halloran, DPM
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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