When do you experience pain?

If the heel hurts, which occurs mainly when standing up, a so-called “lower heel spur” may be present. The lower heel spur is one of the most common degenerative changes of the bony foot. On average, the typical age of the disease is between 40 and 60 years.

The lower heel spur is a bony protrusion in the area of the inner heel bone body immediately below the heel. A lower heel spur can cause severe pain in the heel of the affected person, which increases in intensity especially when standing up. The direct cause for the development of a lower heel spur is a chronic pressure and tensile load of the tendon attachments at the heel bone body.

Due to this strain, pronounced remodelling processes and spur-like bone formation in the area of the lower heel bone occur over time. Increasing age and obesity, as well as overloading or incorrect weight bearing and unsuitable footwear can increase the risk of developing heel pain, which occurs mainly when standing up, many times over.In addition, pain at the bottom of the heel may be associated with so-called plantar fasciitis. Plantar fasciitis is an inflammatory disease of the tendon plate at the bottom of the foot.

Affected persons typically suffer from severe pain at the bottom of the heel. At the beginning of the disease, this pain occurs mainly when getting up and under stress, for example when jogging. In the further course of the disease, however, the heel pain typical of plantar fasciitis can persist even at rest.

The causes of plantar fasciitis are differences in leg length and/or muscular imbalances. In particular, muscular impairment of the hip, imbalance of the lumbar spine muscles and knee joint diseases can increase the risk of developing plantar fasciitis. In addition, pain in the heel, which occurs mainly when standing up, can be provoked by congenital or acquired foot malpositions.

In the long term, only targeted medical treatment can help to provide long-term relief from heel pain. For this reason, persons suffering from corresponding pain symptoms should consult a specialist as soon as possible. A possible cause of pain in the heel after periods of rest can be Achilles tendonitis.

In most cases, the inflammation is caused by overstraining due to too intensive training or unusual strain such as standing on a slope for a long time or hiking. This leads to micro injuries in the tendon, which, however, cannot heal completely due to regular overloading. Patients suffering from inflammation of the Achilles tendon experience pain after resting, which is particularly noticeable in the morning after getting up.

This pain in the heel is also called tarnishing pain. In addition, swelling and redness in the heel area can also occur in this clinical picture. In the case of a chronic inflammation, the pain can already occur at rest.

In order to treat the inflammation, relief is primarily necessary. Therefore, sports activities should be avoided for the foreseeable future. Symptomatically, drugs that have both a pain-relieving and anti-inflammatory effect also help.

Here, preparations from the group of non-steroidal anti-rheumatic drugs (NSAIDs) such as Diclofenac or Ibuprofen are particularly suitable. If this does not help, there is also the possibility of injecting the drug cortisone. Pain in the heel, which occurs mainly in the morning or after resting, is often associated with so-called “achillodynia“.

Achillodynia is a disease of the Achilles tendon, which can lead to severe pain through microtrauma. This disease occurs almost exclusively in athletes and is based on chronic overloading of the tendon attachment to the calcaneus. Achillodynia is considered to be the result of many years of incorrect or excessive strain on the foot.

The typical symptoms of achillodynia include load-dependent pain, which is mainly located in the area of the rear lower leg and the heel. In addition, the main number of affected patients describes pain that occurs in the morning after getting up (so-called start-up pain) and decreases in intensity under normal load. As the disease progresses, however, pain may also occur in the heel, which persists even when the patient is at rest.

People with corresponding pain symptoms should urgently consult a specialist. Only in this way can targeted treatment be initiated and consequential damage prevented. For the treatment of achillodynia, which causes pain in the heel, especially in the morning, non-operative measures are the most suitable.

Early detection of the disease and rapid initiation of appropriate therapy can prevent the disease from progressing and relieve the pain in the heel. In addition to achillodynia, heel pain, which occurs mainly in the morning, can also be associated with osteoarthritis of the ankle. Typically, the affected patients suffer from a pronounced initial pain in the morning.

The pain in the heel may subside if the affected person continues to move. Especially in the morning, walking and standing can be almost impossible, so that the affected patient has to use crutches. Especially at the end of pregnancy, many women suffer from severe pain in the heel.The main cause of this pain is usually the acute weight gain of the expectant mother.

Due to the increasing body weight, there is a significant increase in the load on the bony foot during standing and walking. In addition, the posture of the expectant mother typically changes during pregnancy. As a result, there are pronounced changes in the area of the arch of the foot, so that the longitudinal arch gradually sinks during pregnancy.

These factors can be particularly stressful for the bones, tendons and muscles of the foot and lead to severe pain in the heel. In addition, any water retention (edema) in the area of the feet and lower legs can cause the normally fitting footwear to become too tight and irritate the heel. Especially during pregnancy, however, it is difficult to specifically treat heel pain.

Medicines should only be taken after careful consideration and should always be used sparingly. For this reason, women who suffer from pain in the heel during pregnancy should relieve the affected foot at regular intervals. Raising the feet can also help prevent the formation of water retention. When choosing footwear, care should also be taken to ensure that the shoes do not fit too tightly even at the end of the pregnancy.