Pain in the heel

Heel pain is a common symptom with many different causes. The heel spur and the inflammation of the plantar aponeurosis are particularly frequent causes of the pain. However, incorrect or excessive weight bearing can also lead to pain in the heel, as can incorrect footwear. The therapy is not always easy and often protracted.

Where does the pain occur?

Pain in the back of the heel can indicate a so-called “Achillodynia“. This term refers to a pain syndrome of the Achilles tendon, i.e. the insertion of the calf muscles at the heel bone. The pain at the back of the heel caused by this disease is an inflammatory reaction to mechanical damage to the tendon tissue.

In most cases, the pain is localized approximately one to six centimeters above the base of the calcaneus in the case of achillodynia. The direct cause of the pain at the back of the heel is chronic overloading of the Achilles tendon. Especially constant, uniform movements, for example during long-distance running, can cause such overloading.

In addition, this form of pain at the back of the heel occurs with diseases of the ankle joint and/or foot malformations. In this context, the so-called dorsal heel spur plays a decisive role. The dorsal heel spur causes permanent irritation of the Achilles tendon in affected persons.

As a result, tiny traumas occur in the tendon tissue, leading to severe pain in the back of the heel. The dorsal heel spur is in most cases provoked by postural deformities, incorrect weight-bearing and/or incorrect footwear. For this reason its formation should be prevented in childhood.

The development of a dorsal heel spur, which can lead to severe pain in the back of the heel, can be avoided, especially by choosing suitable shoes. Adults who already suffer from pain in the back of the heel should relieve the affected foot regularly if possible. In particular, shoes without a heel cap and ankle-high shoes can provide sufficient pressure relief for the Achilles tendon.

In addition, the dorsal heel spur can be treated by surgical removal of the excess bone. However, affected patients should note in this context that the remaining scarred tendon tissue can also continue to cause pain at the back of the heel. However, due to the anatomical proximity to the growth plate, surgical correction of a dorsal heel spur can only be performed after skeletal growth has been completed, i.e. at the age of 16 to 17 years.

Pain in the heel, especially if it exists on the inside, can be caused by a so-called kink-lower foot. This causes weakness of the tendons and ligaments that normally maintain the longitudinal arch of the foot. A sinking of the arch of the foot leads to a complete change in the statics, so that the load points of the foot also change. This results in an increased pressure load on the inside of the heel, which can cause pain as a result. A lower heel spur or an inflammation of the plantar tendon, which is a large tendon in the area of the sole of the foot, can also cause pain in the area of the inner heel.