Skin changes and other causes
Changes in the skin, such as calluses or warts, can also be considered a cause of heel pain. Calluses typically form on highly stressed areas of the skin, such as the heel. The occurrence of calluses is promoted by unfavorable footwear, bone excrescences, foot anomalies and other causes.
Warts occur mainly in children and can also be observed on the sole of the foot. The cause of a wart is infection with the human papilloma virus (HPV), this virus can enter the skin thanks to small tears or injuries. The cause of heel pain can also be outside the locomotor system and skin.
For example, metabolic diseases such as gout (hyperuricemia) or diabetes mellitus can also cause foot or heel pain. Plantar fasciitis People who suffer from plantar fasciitis typically complain of pain that is most pronounced in the morning after getting up or after prolonged rest. After a short period of time, the symptoms usually improve, although they may return over the course of the day after prolonged stress.
The complaints can become so severe that they can even lead to inability to walk. Foot anomalies Foot anomalies, such as flat feet or a kink-lower foot combination can be recognized by the shape deviation of the foot. They can also be a cause for heel pain.
In addition, they usually make themselves felt through other complaints, such as restrictions in mobility. Although the Os trigonum, an extra foot bone on the talus, is more likely to cause pain behind the outer ankle, these complaints can also radiate into the heel and Achilles tendon. Atrophy of the heel fat pad The atrophy of the heel fat pad causes heel pain, which is mainly located centrally below the heel and occurs when walking.
Heel spur Another common clinical picture that causes heel pain is the heel spur. Affected persons often have the feeling of a nail in the sole of the foot. This means that the pain caused by a heel spur is usually sharp or burning and is particularly intense in the morning when taking the first steps after getting up from bed.
After a certain period of exertion, the intensity of pain usually decreases again. Experience shows that pain can also be triggered by pressure on the affected area.For example, the more frequent lower heel spur causes a pressure pain on the sole of the foot below the heel. In the case of an upper heel spur, the pressure on the base of the Achilles tendon causes pain in the rear upper part of the heel.
The affected area may also show swelling and redness. Haglund’s exostosis The congenital Haglund’s exostosis does not necessarily lead to pain. These typically occur as a result of external pressure, such as the pressure of shoes.
In addition, a Haglund exostosis can lead to swelling at the base of the Achilles tendon. Reddening of the skin or inflammation of the bursa can also be added to the heel pain. Bone cyst The fluid-filled cavity in the heel bone can be asymptomatic.
However, pain may occur under stress. Occasionally, swelling may also develop. A bone cyst promotes the occurrence of a bone fracture.
Bone tumors The symptoms of a bone tumor depend on the particular form. For example, benign osteoid osteomas typically cause severe pain at night, but they react extremely well to painkillers such as acetylsalicylic acid, or ASA for short. A tumor in the bone also promotes the occurrence of a fracture.
Fatigue fracture of the calcaneus Indications of a fatigue fracture of the heel are usually obtained by interviewing the patient (anamnesis), in which known bone diseases and sports activities should be taken into account. In addition, heel pain occurs successively and increases in intensity under stress. Swelling of the heel area can also be observed.
Apophysitis calcanei Apophysitis calcanei can be considered the most common cause of heel pain in the growth phase. This pain usually worsens under stress. A limping after straining the heel bone can also be observed.
The heel region may also react sensitively to external pressure and show redness and swelling. Pathological changes of the Achilles tendon Acute inflammation of the Achilles tendon leads to stabbing pain, especially under stress, as well as swelling in the area of the tendon. Chronic changes in the Achilles tendon are more likely to cause discomfort during the first steps in the morning, which then diminishes with further strain.
Only overstrain or rest lead to a renewed increase in intensity of the pain. The Achilles tendon can be painful at certain points due to pressure and can also be thickened. Fine tears of the tendon are usually asymptomatic, whereas patients with a complete tear of the Achilles tendon (Achilles tendon rupture) report severe pain.
Torn Achilles tendon (Achilles tendon rupture) Patients usually report a whip-like noise that occurred during the trauma. Fresh tears also have a palpable gap, most often a few centimeters above the tendon attachment to the heel bone. The affected area becomes bloodshot and swollen after some time.
Walking on the tips of the toes is difficult or no longer possible for patients with a tear of the Achilles tendon. Skin lesions Calluses, which are actually a protective barrier, can also be a reason for heel pain. A wart can either be superficial (so-called mosaic warts) or it can reach deep into the skin. Especially the thorny warts that penetrate into the depths can cause heel pain when walking.
