Heel Pain Treatment

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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

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What is Heel Pain?

Heel pain encompasses discomfort felt in the heel area, commonly caused by excessive stress on the feet.

This condition may be indicative of chronic conditions such as plantar fasciitis, Achilles tendonitis, or heel spurs, which may limit mobility and negatively affecr daily activities.

Causes of Heel Pain

Heel pain is often caused by repetitive stress on the feet. This can occur through activities such as playing sports on hard surfaces or wearing shoes that irritate sensitive tissues.

Common conditions causing heel pain may include:

  • Plantar Fasciitis
    Frequently seen in individuals who engage in extensive running or jumping, plantar fasciitis is an inflammation of the tissue band connecting the heel bone to the base of the toes. Continuous strain and overuse can cause discomfort in the heel area.
  • Stone Bruise
    This results from stepping on a hard object, causing a bruise on the heel’s fat pad. The direct impact causes immediate discomfort and can lead to persistent pain if not addressed.
  • Heel Spur
    A prolonged case of plantar fasciitis may lead to the formation of a heel spur. This bony growth or calcified deposit forms as a result of ongoing stress and inflammation in the heel, often manifesting as a sharp, localised pain.
  • Achilles Tendinitis
    Characterised by irritation and inflammation of the Achilles tendon, this condition is typically a consequence of excessive running or wearing improperly fitting shoes that rub into the back of the heel.
  • Bursitis
    Inflammation of the bursae, small fluid-filled sacs near the heel, can cause pain due to irritation and swelling in the area.
  • Haglund’s Deformity
    This is a bony enlargement on the back of the heel that can lead to painful bursitis due to irritation from shoes.
  • Sever’s Disease
    Commonly seen in active children and adolescents, this condition involves inflammation of the growth plate in the heel, leading to pain, especially during physical activities.

Symptoms and Signs

Common indications of heel pain include:


  • Swelling in the Heel: Swelling often indicates inflammation or irritation in the heel area. It can be a response to an injury or a sign of an underlying condition affecting the heel.
  • Redness in the Heel: Similar to swelling, redness can signify inflammation. It may be accompanied by warmth and tenderness, pointing towards an active inflammatory process.
  • Difficulty Walking Due to Pain: Heel pain can impair mobility, making it challenging to walk or bear weight on the affected foot. This symptom can interfere with daily activities and affect quality of life.

Diagnosis

The diagnostic process for heel pain typically involves the following steps:

  • Medical History Review: Diagnosis starts with a review of the patient’s medical history and symptoms. This provides insight into potential causes and risk factors.
  • Physical Examination: A thorough examination of the feet is conducted to identify the exact site and cause of the pain. The heel specialist assesses for tenderness, swelling, redness, and any abnormalities in the structure or function of the foot.
  • Imaging Tests: Depending on the initial assessment, further tests such as X-rays, MRI scans, or ultrasound may be employed to confirm the diagnosis or rule out other conditions.

Non-Surgical Treatment Options

For most individuals, heel pain can be effectively managed with non-surgical treatments. These interventions aim to alleviate pain and inflammation while improving foot flexibility.

Rest and Ice Application

Initially, the heel specialist may suggest resting the affected foot and applying ice to reduce swelling and alleviate pain.

Medications

Over-the-counter pain relief and anti-inflammatory medications may be prescribed to manage pain and reduce inflammation.

Orthotic Devices and Taping

Shoe inserts, both over-the-counter and custom-made, can provide support and relieve pressure on the heel. Night splints and walking boots may be needed in more severe cases. Athletic or medical tape can also be used to support the foot arch or heel, providing relief and stability.

Physical Therapy

Techniques like massage, ultrasound therapy, and specific exercises can help break up soft tissue adhesions. This allows for a reduction of pain and inflammation.

Stretching Exercises

Regular stretching of the calf muscles and plantar fascia can improve flexibility and reduce tension in the feet, aiding in pain relief.

Surgical Treatment Options

While rare, certain cases of heel pain may require surgical intervention, especially if non-surgical treatments fail to provide relief.

Plantar Fascia Release

This procedure involves cutting part of the plantar fascia to release tension and relieve inflammation. It is typically reserved for severe cases of plantar fasciitis.

Removal of Heel Spurs

If a heel spur is causing severe pain and has not responded to other treatments, surgery may be necessary to remove the spur.

Achilles Tendon Surgery

In cases where Achilles tendinitis is severe and persistent, surgical intervention may be required to repair the Achilles tendon.

Bursa Excision

If bursitis is the primary cause of heel pain, surgery to remove the inflamed bursae might be considered.

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Prevention Strategies

Certain measures may reduce the risk of developing heel pain.

  • Wearing Appropriate Footwear to Protect the Heel - Choose shoes with adequate arch support, cushioning, and a proper fit. This can be beneficial for those involved in activities involving prolonged standing or physical exercise.
  • Maintaining a Healthy Weight - Maintaining a healthy weight reduces strain on the feet, thereby decreasing the risk of heel pain.
  • Regular Stretching of the Feet - Stretching exercises for the calf muscles and plantar fascia can improve flexibility and reduce tension in the feet, preventing heel pain.
  • Gradual Increase in Physical Activity - Increasing the intensity of exercise routines gradually allows the feet to adapt, reducing the risk of heel pain.
  • Adequate Rest and Recovery for the Feet - Allowing sufficient time for the feet to rest and recover, especially after intense activities or experiencing pain, can prevent exacerbation of heel pain.
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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

With over 18 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.

  • Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
  • Member, Royal College of Surgeons of Edinburgh (MRCSEd)
  • Master of Medicine (Orthopaedic Surgery), National University of Singapore
  • Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
  • Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany

 

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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
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Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed

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    Mount Elizabeth Novena Specialist Centre
    38 Irrawaddy Road, #08-62/63
    Singapore 329563

    Frequently Asked Questions (FAQ)

    Can I Walk with Heel Pain?

    While it may be possible to walk with mild heel pain, this should be done in moderation to prevent straining the foot. Activities that exacerbate the pain should be limited, and the foot should be rested regularly to alleviate symptoms. If you experience persistent or increasing discomfort, consult our heel specialist for a prompt evaluation and effective management strategies.

    What Exercises Should I Avoid with Heel Pain?

    Avoid high-impact exercises that put excessive stress on the heel, such as running, jumping, or activities on hard surfaces. Opting for low-impact activities like swimming or cycling can help maintain fitness without aggravating heel pain.

    What Happens if Heel Pain is Left Untreated?

    Neglecting heel pain can lead to worsening symptoms and potentially chronic conditions, affecting mobility and quality of life. Early intervention by a heel specialist can prevent complications and ensure effective treatment.

    How Do I Know If My Heel Pain Warrants Medical Attention?

    Heel pain that persists, worsens, or impacts daily activities should be evaluated by a heel specialist. Signs such as swelling, redness, or difficulty walking are indicators that medical intervention is necessary for accurate diagnosis and treatment.