Everything was just fine, now your heel hurts. The pain often indicates overloading of the foot. But there are also other possible causes, because a foot has a complex structure: 26 bones, 33 joints, over 100 ligaments, 20 muscles with strong tendons. In principle, any of these structures can be damaged. The reasons for heel pain, which doctors also call tarsalgia, are correspondingly diverse.
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Pain that you feel on the back of your foot often originates in the heel bone. This is the largest and rearmost tarsal bone. Tendons, ligaments and muscles are connected to it, for example the Achilles tendon.
This connects the calf muscles with the foot skeleton. Along the sole, in the direction of the toes, the plantar fascia, a strong tendon plate, stretches from the heel bone. In addition to bones, the soft tissues of the foot can also be affected by diseases. These can all be reasons why the heel hurts.
The treatment of heel pain always depends on the diagnosis. In some cases you can treat the symptoms yourself, but sometimes heel pain is also a case for the doctor – depending on the cause or underlying disease.
See a doctor right away if the pain comes on suddenly or is severe. This applies in particular if an accident such as a fall or hit happened beforehand. The doctor can use ultrasound, X-rays or palpation to identify typical accident injuries and treat them immediately. These include, for example, ligament tears – partial or complete – and broken bones.
You should always have not only acute but also long-term complaints clarified by a doctor: Go to the doctor if the heel pain does not go away even after two weeks of rest or even gets worse. The same applies in the event that the symptoms recur again and again.
The doctor can find out the cause of the pain. He uses, for example, the doctor’s consultation or the ultrasound and X-ray examination for diagnosis. Once the underlying disease of the heel pain has been determined, the doctor knows what helps and starts causal treatment.
This therapy can vary greatly from case to case. Some examples:
If conservative therapies (without surgery) have no effect, an operation may also be necessary. A heel spur, for example, can be removed as part of a surgical procedure. This is a small thorn-like ossification on the heel that can cause sharp pain. A heel spur is a result of chronic overuse. This constantly causes small tendon injuries, which gradually calcify.
You can also relieve slight heel pain yourself. The first step is to put your feet up! Rest and relaxation are especially good after a temporary load, for example when your heel hurts after sport. Cooling, for example with a cold compress, can also be a simple but effective method of relieving heel pain yourself. If you want to use herbal medicine, you can apply an arnica gel, for example.
Once the acute pain has subsided, you can train your legs and feet to prevent the pain from coming back. Stretching and strengthening exercises are good:
You should discuss which exercises are suitable for your individual situation with your doctor or physiotherapist. This is especially true after injuries.
Heel pain can have many different causes. Overloading is particularly common. For example, constant irritation can inflame the tendons or form a heel spur. A typical symptom of heel spurs is that the pain can be felt in the morning when it first occurs. When you are resting, for example when you are sitting or lying down, the heel pain subsides.
Constant stress on the heel can be promoted, for example, by being overweight, misaligned or poorly cushioned shoes. In addition, advanced age is also a risk factor, because over time the elasticity of the tendons decreases or the shock-absorbing fat pad of the heel decreases.
The heel is also subjected to heavy loads in certain types of sport, especially when running. Water aerobics or swimming are therefore more suitable for heel pain, as the weight load in the water is reduced.
Another typical cause of heel pain is injury. Stumbling, falling, being hit or hit can break foot bones or cause painful bruises. Ligaments and tendons can be severely stretched and tear partially or completely.
A torn ankle ligament, for example, is a typical sporting accident or the result of spraining. You can recognize a tear – in addition to pain in the affected area – from lateral swelling and bruising just above the heel.
Another reason for heel pain can be rheumatism. There are many different manifestations of rheumatic diseases, which can be divided into two large groups:
Both arthritis and arthrosis can cause problems in the ankles – and thus pain in the heel area. Rheumatic diseases are widespread: around 20 million people in Germany are affected, including children. Since small children in particular are often unable to name pain or not specifically, you should also pay attention to changes in movement sequences and protective postures.
Growth can also trigger heel pain in children: around the age of 12 to 13, the growth plate of the heel bone closes. During this process, cartilage tissue is converted into bone, which can be painful. However, heel pain usually goes away completely once growth is complete.
If you have heel pain, you can first contact your family doctor. If necessary, they will refer you to a medical specialist. In the case of foot pain, this is often an orthopedist. These doctors are the specialists for the musculoskeletal system. They treat diseases and injuries of the bones, joints, ligaments, tendons and muscles.
Other specialists who come into question for heel pain are, for example, trauma surgeons, sports medicine specialists or specialists in internal medicine and rheumatology.
If your child complains of a sore heel, the pediatrician is the first point of contact.
This article was written by Katharina Kunzmann, medical journalist
The original of this post “Heel pain: every step is torture” comes from FOCUS doctor search.