Brief overview
- Causes: Tendonitis of the sole of the foot (plantar fasciitis or plantar fasciitis), heel spur, pathological changes of the Achilles tendon, bursitis, bone fracture, Bechterew’s disease, S1 syndrome, tarsal tunnel syndrome, congenital fusion of heel bone and navicular bone
- When to see a doctor? If the heel pain persists for a longer period of time, increases under stress, restricts walking or is accompanied by other complaints such as joint swelling.
- Treatment: depending on the cause, e.g. in the case of heel spurs, special shoe inserts, painkillers, physical therapy and, if necessary, surgery. If there is no underlying disease: Tips and exercises against heel pain.
- Tips and exercises: Avoid overweight, have malpositioned feet corrected, avoid excessive sitting, avoid tight shoes, warm up before exercise, exercise moderately, elevate foot in case of acute pain (e.g. when running), cool and take it easy.
Heel pain: Causes
Tendon plate inflammation of the sole of the foot (plantar fasciitis or plantar fasciitis).
Plantar fasciitis is a wear-related (degenerative) disease of the tendon plate attachment to the calcaneal tuberosity (heel bone bump). The tendon plate connects the calcaneal tuberosity to the ball of the foot, and together they form the longitudinal arch of the foot. Plantar fasciitis causes pressure pain in the heel.
Heel pain as a result of plantar fasciitis is usually caused by sports-related stress, such as running or jumping. However, the condition can also occur due to age as a result of natural wear and tear.
Heel spur
Pain in the heel can also indicate a heel spur. This is a thorn-like bone outgrowth on the heel bone, but it does not necessarily hurt.
The lower (plantar) heel spur (calcaneal spur) originates on the underside of the calcaneal bump, where the short muscles of the foot and the tendon plate of the sole of the foot begin. It triggers severe pressure pain at the mid-lower end of the calcaneus. When weight is placed on the foot, stabbing pain is added to the sole of the foot. In extreme cases, the affected person can only step with the forefoot.
A heel spur can also occur together with tendon plate inflammation of the sole of the foot (plantar fasciitis).
Pathological changes of the Achilles tendon
Bursitis
Two bursae are located in the area of the Achilles tendon insertion and the heel bone. When they become inflamed, heel pain often results.
One of the bursae is located between the Achilles tendon and the heel bone (bursa subachillaea). It can become inflamed, for example, due to an upper heel spur, overuse or certain diseases such as gout.
Bone fracture
A bone fracture in the heel area, for example a calcaneal fracture, can also result in heel pain. In most cases, a bone fracture is caused by an accident. However, there are also so-called fatigue fractures (stress fractures). They can occur in bones that are subjected to high stress, for example in professional runners. The tibia, metatarsus and heel are particularly frequently affected. In the latter case, heel pain results.
Bechterew’s disease (ankylosing spondylitis)
Common symptoms of ankylosing spondylitis include joint inflammation, morning stiffness in the joints, and alternating buttock pain. In this case, the lumbar spine often has limited mobility, and the pain radiates into the thighs, and not infrequently even into the heels.
S1 syndrome
Tarsal Tunnel Syndrome
Another sign of tarsal tunnel syndrome: the sole of the foot secretes significantly less sweat than normal.
Fusion of calcaneus and navicular bone (coalitio calcaneonaviculare).
Heel pain: tips and exercises
Do you already suffer from heel pain or would you like to prevent heel pain effectively? Then the following tips and exercises can help you.
If you have had heel pain for a long time, you should always consult a doctor (family doctor or orthopedist) to clarify the causes of your complaints. The tips and exercises mentioned can then be carried out in addition to medical treatment by the doctor.
Tips against heel pain
- Avoid excess weight: Every excess kilo puts stress on the feet and promotes heel spurs and other foot problems. So make sure you maintain a healthy body weight. If you are overweight, you should try to lose weight.
- Have deformities of the feet corrected: Misalignments like a flat foot can cause a heel spur, triggering heel pain. Therefore, you should have misalignments of the feet treated.
- avoid excessive sitting
- avoid tight shoes
- Exercise moderately: Don’t overdo it with the training. This will help avoid painful fatigue fractures, for example, in the heel.
- Apply first aid measures: For acute heel pain, elevate the affected foot, cool it and rest it.
Exercises against heel pain
Experts recommend regular calf training to prevent heel pain or relieve acute discomfort. To do this, you can, for example, do the following stretching exercises every day:
Exercise 1 against heel pain
Exercise 2 against heel pain
Stand with the balls of your feet backwards on a stair step and hold on to the railing with one hand. Now slowly push your heels down as far as you can. Hold the position for 10 seconds and repeat the exercise 20 times.
The two exercises are also good for your warm-up program before sports.
Heel pain: description and forms
Depending on where exactly the pain is localized, a distinction is made:
- lower or plantar heel pain: This is pain under the heel. It is often caused by inflammation of the tendon plate (plantar fasciitis) or a lower heel spur.
- Upper or dorsal heel pain: This is pain at the base of the Achilles tendon. This heel pain usually occurs when the Achilles tendon attachment site is overused or inflamed, or when an upper heel spur is present.
A visit to the doctor is indicated for:
- prolonged heel pain
- heel pain that increases under stress
- heel pain that restricts walking
- heel pain that is accompanied by other complaints, for example joint swelling
Heel pain: What does the doctor do?
In conjunction with the medical history, various examinations can help identify the cause of heel pain. The most important examinations include:
- Physical examination: here the doctor tests, for example, whether there is pressure pain or bony swelling in the heel area, which could indicate a heel spur. He also checks, among other things, how mobile the joints are, how strong your muscles are and whether you can walk normally.
- Magnetic resonance imaging (MRI): If the doctor suspects that pathological changes in the Achilles tendon are behind the heel pain, he can investigate this suspicion with the help of an MRI. Bechterew’s disease can also be detected with an MRI.
Heel pain: treatment
Frequently asked questions
You can find the answers to the most frequently asked questions about this topic in our article Frequently asked questions about heel pain.