When your heel hurts: information on heel pain and conditions

The calcaneus is the largest bone in the foot, located at the back of the foot, and its primary function is to absorb impact during walking. Together with the talus and cuboid, the calcaneus provides a base of support for the entire body, playing a crucial role in supporting body weight and propulsion during walking.

When the heel hurts, this pain can be caused by various conditions, each with specific characteristics.

One of the most common causes of heel pain is plantar fasciitis, or heel spur , characterized by inflammation of the plantar fascia, the tissue that connects the heel to the toes. If the inflammation affects the Achilles tendon and is due to repetitive overuse, it is called tendinitis. It is associated with pain and stiffness at the back of the heel, especially upon waking.

Finally, when inflammation affects the bursae, the protective cushions between bones and soft tissues, we call it bursitis, with swelling and tenderness. The heel can hurt due to microfractures caused by repetitive or excessive loads on the foot, which cause persistent pain, or due to the formation of a heel spur, which can cause localized, sharp pain, often felt when putting weight on the heel.

Diagnosis of heel pain

Diagnosing heel pain requires a thorough clinical evaluation. During the visit, the doctor performs a physical exam to identify areas of pain and swelling. Specific imaging tests (such as X-rays, ultrasound, or MRI) can confirm the diagnosis and identify any bone or tissue abnormalities.

Depending on the underlying cause, specific treatments are provided:

• For plantar fasciitis and heel spurs, rest, ice application, and the use of foot orthotics are often effective.
• Tendinitis involving the Achilles tendon can be treated with physiotherapy and, in more severe cases, with corticosteroid injections to reduce pain.
• Bursitis requires anti-inflammatory therapies and, in some cases, fluid aspiration.
• Stress fractures require immobilization and prolonged rest.
• For arthritis, specific medications may be prescribed to reduce inflammation.

Heel pain prevention

Some simple good habits are very important for alleviating heel pain. Wearing appropriate shoes with good heel support and maintaining a healthy body weight can reduce pressure on the foot. Performing simple calf stretching exercises, on the other hand, helps improve flexibility and muscle strength, reducing the risk of injury.

Surgery to resolve heel pain

In some more severe cases, when the pain becomes unbearable and conservative treatments have been unsuccessful, surgery may be curative. The type of procedure varies based on the severity of the condition. It may include heel spur removal, Achilles tendon repair, or deformity correction. Recovery requires a personalized rehabilitation program to restore foot function.

For patients with severe joint problems, ankle replacement represents an effective solution. The procedure involves replacing the damaged joint with an artificial prosthesis. Advances in materials and prosthetic designs, along with increased understanding of foot biomechanics, ensure significant clinical results, potentially eliminating heel pain. Post-operative rehabilitation is essential to ensure a good functional outcome and improve quality of life.

The Smarthallux method

If you suffer from heel pain, it's important to get an accurate diagnosis. You can book a consultation with Dr. Luigi Manzi or one of his associates at one of the specialized clinics in Milan, Rome, or Naples. Smarthallux centers use innovative technologies, such as stem cell therapy, to promote faster healing and reduce the risk of recurrence. Telemedicine consultations are also available. For quick, accessible support and transparent service costs, book a consultation now.