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Pain in the Heel

By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Heel spurs and heel pad irritation are the two most common causes of heel pain and is due to overload. Relief is the best treatment. Upon failure of relief, your doctor may inject corticosteroid into the heel, refer you to physical therapy or perform surgery. Both conditions are lengthy and disappear only after several months.

Under the great heel bone is a heel pad that protects the bone against shock when you walk or run. The heel pad acts as an "air bag". If the heel is exposed to many shocks - for example, by running on concrete or numerous hop on a hard surface – the tissue crushes in in the heel pad and there comes pain. The load and the rays towards the toes trigger the pain.

From the large heel bone and out to the toes, you have a wide collection of tendons - called a tendon plate where the foot rests. By overload - for example, by walking or running on hard surfaces – the tendons and can become irritated, resulting in pain. The pain is most pronounced in the morning, just when you get out of bed and decreases when you walk in the foot. The pain is increasing again after some time load. The pain is localized at a particular point about five cm from the back of the heel. The place is sore to pressure. Sometimes - but not always - can form a small bone - a so-called heel spurs.

Both heel spurs and heel pad irritation are due to overload of the micro-damage in the tissue - either in the heel pad, or in the tendon plate.

What can you do?

Since both modes are due to overloads, relief is the main treatment. Avoid standing, walking or running on a hard surface. When you run - run on a soft surface - trails or grass. Protect the heel pad with an extra "airbag" in the shoe - for example gel in heel of the shoe, or other shock absorbing posts. If you are overweight, a weight loss can reduce the load on the heel significantly. Protect the tendon late plate with a good and strong length bow in your shoes. Ordinary painkillers (such as paracetamol, aspirin or ibuprofen) - which can be purchased over the counter – usually alleviates the pain.

What can your doctor do?

If you after a month of relief and painkillers still has daily pain, you should consult your doctor. The doctor may inject corticosteroid into the heel or refer you to physical therapy or surgery by a specialist.

What can a specialist doctor do?

In rare cases, surgery for heel spurs is necessary. There may be formed a large heel spurs, which can be removed. A follow-up shows that only half of the operated is satisfied with the result.