For a healthy gait, the foot rolls over the heel and the ball of the foot. If the heel hurts, walking becomes a burden. Heel pain, also known as tarsalgia, can manifest itself in very different forms of pain. Depending on its severity, even simple walking can cause great difficulty for those affected. The cause is usually treated. The heel pain then also disappears.
Here you will find further information and selected doctors for heel pain.
Heel pain (ICD code: M79.67) can manifest itself in different ways. Some patients suffer from initial pain that occurs after prolonged sitting or lying down. It improves with movement. This initial pain can be mild or so severe that the first steps can only be taken with a limp.
Heel pain can also take the form of
occur. Some patients report dull or pressing heel pain at rest. The possible causes of this pain can be very different.
Heel pain - pain symptom of various diseases © cirquedesprit / Fotolia
Overloading and incorrect loading of the feet are a common cause of heel pain. Other causes can be
Inflammation of the tendons
In particular, the Achilles tendon(achillodynia) is most commonly affected and can lead to pain at its attachment point on the heel. The plantar tendon( plantarfasciitis ), which stabilizes the sole of the foot and attaches to the heel, is also one of the (albeit much rarer) causes of heel pain.
Heel spur (calcaneal spur)
The heel spur(calcaneal spur) is a bony protrusion on the heel that can cause pain, particularly when pressure is applied, but later also at rest. An inflamed tendon attachment on the heel bone also leads to heel pain. This inflammation often occurs in combination with a so-called upper heel spur. The upper heel spur forms on the upper part of the heel bone in the attachment area of the Achilles tendon. The inflamed tendon insertion calcifies.
Risk of overloading: the weight of the body rests on the bones of the foot, especially the heel bone. © bilderzwerg / Fotolia
Haglund's heel
Haglund's heel is typically characterized by the formation of an excess bone in the heel area, which can be congenital (e.g. in the case of foot malpositions such as hollow foot) or acquired (e.g. due to excessive running training). As a result, inflammation occurs in the attachment area of the Achilles tendon, which can lead to ossifications. Haglund's heel is also referred to as an upper heel spur, as the ossification points upwards (towards the Achilles tendon).
Foot deformities
These include, in particular, common deformities such as bowed, flat and fallen arches.
Rheumatism and metabolic diseases
Rheumatism and metabolic diseases such as gout or diabetes mellitus also often lead to joint and bone pain, which is particularly pronounced in the morning and gets better as the day progresses.
Circulatory disorders
The opposite is true for the most common type of circulatory disorder, so-called intermittent claudication. In this case, the pain occurs particularly during exertion and disappears again at rest. The cause of this circulation-related pain is narrowed or blocked arteries in the leg, which can still maintain the blood supply at rest. However, the pain increases under stress, forcing the patient to take short breaks from standing or sitting. This is where the term intermittent claudication comes from.
Vascular occlusion and poor circulation in the feet can lead to heel pain. © pankajstock123 / Fotolia
The most common cause of pain in the upper part of the heel is inflammation of the Achilles tendon, known as achillodynia. The heel pain in achillodynia usually occurs at the upper edge of the heel bone, as this is where the tendon attaches. This is why the combination of achillodynia and Haglund's heel (= upper heel spur) is frequently observed.
Achillodynia is mainly caused by overloading. Ill-fitting footwear can also promote the development of Achilles tendinitis.
Inflammation of the Achilles tendon manifests itself as stabbing heel pain, which worsens during physical activity. The affected tendon is also thickened and sensitive to pressure, and sometimes reddened.
Inflammation and injuries to the Achilles tendon lead to heel pain. © bilderzwerg / Fotolia
In plantar fasciitis, the tendon plate of the sole of the foot (plantar fascia) is inflamed. The heel pain occurs at the bottom, towards the sole of the foot, and is particularly bad when walking. Plantar fasciitis is often combined with a lower heel spur, as the plantar fascia attaches to the heel from below. Comparable to the upper heel spur as an ossification in Achilles tendinitis, the lower heel spur in plantar fasciitis is an ossification on the lower part of the heel.
If the foot is overloaded or incorrectly loaded, the tissue in the area of the sole of the foot around the heel spur can become inflamed. Women between the ages of 50 and 60 in particular suffer from plantar heel pain. The pain typically occurs in the morning after getting up.
Flat feet can vary in severity. Bow-legged flat feet are congenital or acquired foot deformities. The causes are
Depending on the severity and cause, movement restrictions may occur quite early on. Foot or heel pain can then occur when walking or running.
Cause of heel pain: misalignment of the feet. © bilderzwerg / Fotolia
The cause of heel pain is not always found directly in the foot. Morning heel pain on both feet, for example, is the main symptom of the rheumatic disease ankylosing spondylitis. Rheumatic diseases can also affect the feet. Rheumatic pain in the foot and heel is caused by inflammatory processes. Rheumatic heel pain is therefore always treated together with the underlying disease rheumatism.
The metabolic diseases gout and diabetes mellitus can also cause pain in the heels. Gout increases the uric acid levels in the blood. Diabetes mellitus is characterized by high blood sugar levels.
Both diseases can cause
and thus lead to heel pain.
Most of the causes of heel pain can be found in the musculoskeletal system . That's why trauma surgeons, orthopaedic surgeons and foot surgeons are the right people to contact for heel pain. They deal with deformities and diseases of the musculoskeletal system.
The exact nature and development of the symptoms will be determined in a medical history interview:
During the subsequent physical examination, the following are assessed
Ultrasound and X-ray examinations can be used to assess the foot structures more precisely. Magnetic resonance imaging(MRI) is also suitable for clarifying heel pain. An MRI is particularly helpful if there is a suspicion of inflammation of the soft tissue and the bone is unremarkable on X-ray.
Doctors who specialize in heel pain originating from the bone or joints are trauma surgeons or orthopaedic surgeons. However, if an underlying systemic disease is suspected, it may be necessary for you to be referred to another specialist. Depending on the suspected underlying disease, this could be a
be.
In principle, movement and stretching exercises can alleviate heel pain, regardless of the cause. Particularly for chronic complaints
are useful and helpful.
Further treatment of heel pain depends primarily on the cause of the pain:
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A healthy diet helps with underlying systemic diseases and can therefore alleviate heel pain. © Syda Productions / Fotolia
If all the conservative treatment measures described above are not sufficient for a heel spur, surgery may be necessary. The bony protrusion is completely removed endoscopically. The procedure itself is minimally invasive and belongs to the field of foot surgery. The patient then receives comprehensive follow-up care to prevent a recurrence of the heel spur.
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