Definition
Heel pain is one of the most common foot complaints and can lead to a considerable reduction in the quality of life of those affected. Mainly a heel spur, inflammation of the Achilles tendon, plantar warts or inflammation of the bursae lead to pain in the heel bone. In addition, excessive athletic strain, excessive body weight, unsuitable or inappropriate footwear or malpositioning of the feet often also play a role.
Causes
Heel pain, also known as tarsalgia in medical jargon, can have a wide variety of causes. Important, also for the diagnosis, is the distinction between lower or plantar heel pain and upper or dorsal heel pain. The lower or plantar heel pain is located under the heel, whereas the upper or dorsal heel pain represents pain at the base of the Achilles tendon. The various causes of heel pain are briefly discussed below. This list contains the most important triggers for heel pain.
Plantar fasciitis
Plantar fasciitis is an inflammatory disease of the tendon plate of the sole of the foot (Aponeurosis plantaris), as the suffix -itis in the term “plantar fasciitis” suggests. Plantar fasciitis is the most common cause of pain in the heel. Approximately 10% of the population suffers from plantar fasciitis once in a lifetime, with women generally being affected more often than men.
In addition, the frequency of this clinical picture also increases with age and the Body Mass Index (BMI) or weight. Standing or walking occupational groups and runners, as well as people with foot anomalies, such as a flat foot or different leg lengths, are more frequently affected by plantar fasciitis. In athletes, however, there is no correlation between the occurrence of plantar fasciitis and body weight.
Foot anomalies
Congenital or acquired foot anomalies, such as a kinked, fallen arches or flat feet are also a cause of heel pain. Surplus bone (accessory bone) in the foot, such as the so-called Os trigonum, can also be a cause of heel pain in some cases. Atrophy of the heel fat pad In medical jargon, atrophy is defined as a loss of tissue.
This can also manifest itself in the heel, where the heel fat pad normally serves as a natural shock absorber. In addition, injections of cortisone into this area can also lead to shrinkage of the heel fat pad. Anorexia nervosa can also cause shrinkage of the heel fat pad.
Over time, the bursa under the calcaneus becomes irritated and/or a heel spur develops in this area. Heel spur A so-called heel spur is a thorn-shaped bone outgrowth on the heel bone. One can differentiate between the rarer upper (posterior, dorsal) and a lower (plantar) heel spur.
A lower heel spur can occur together with an inflammation of the tendon plate of the sole of the foot (plantar fasciitis). Heel spurs are also quite common, although a heel spur does not necessarily cause discomfort. A good way to visualize a heel spur is an x-ray. Haglund’s exostosis The Haglund’s exostosis is a congenital form variant of the heel bump of the calcaneus, whereby the lateral and rear part is particularly prominent. This deviating form of the heel is called the Haglund heel after the first describer.
