Our heel are anatomically designed in such a way that they can bear a heavy load, but too much stress pushes them over their limit. When you pound your feet on hard surfaces playing sports or wear shoes that irritate sensitive tissues, you may develop heel pain, the most common problem affecting the foot and ankle.

Pain beneath the heel

Stone bruise: When you step on a hard object such as a rock or stone, you can bruise the fat pad on the underside of your heel. It may or may not look discoloured. The pain goes away gradually with rest.

Plantar fasciitis (Subcalcaneal pain): Doing too much running or jumping can inflame the tissue band (fascia) connecting the heel bone to the base of the toes. The pain is centered under the heel and may be mild at first but flares up when you take your first steps after resting overnight. You may need to do special exercises, take medication to reduce swelling and wear a heel pad in your shoe.

Heel spur: When plantar fasciitis continues for a long time, a heel spur (calcium deposit) may form where the fascia tissue band connects to your heel bone. Your doctor may take an X-ray to see the bony protrusion, which can vary in size. Treatment is usually the same as for plantar fasciitis: rest until the pain subsides, do special stretching exercises and wear heel pad shoe insert.

Pain behind the heel

If you have pain behind your heel, you may have inflamed the area where the Achilles tendon inserts into the heel bone (Retrocalcaneal bursitis). People often get this by running too much or wearing shoes that rub or cut into the back of the heel. Pain behind the heel may build slowly over time, causing the skin to thicken, get red and swell. You might develop a bump on the back of your heel that feels tender and warm to the touch. The pain flares up when you first start an activity after resting. It often hurts too much to wear normal shoes. You may need an X-ray to see if you also have a bone spur.   

Treatment for Heel Pain

Treatment includes resting from the activities that caused the problem, doing certain stretching exercises, pain medication and wearing open back shoes. Physiotherapy is an excellent treatment option for heel pain. Use of non-steroidal anti-inflammatory medications for pain and swelling. Placing ice on the back of the heel to reduce inflammation.

Physiotherapy treatment includes: Ultrasound therapy, Wax bath, Hot pack and Cryotherapy.

Your Physiotherapist may advise you stretching exercises like stretching of Achilles tendon by leaning forward against a wall with your foot flat on the floor. You may also be advised heel inserts or cushions.