As the contact surface between the body and the ground, feet absorb high levels of energy. Although the human foot is exquisitely structured to fulfill this function, it remains susceptible to irritation and injury. As the striking point during walking and running, the heel is frequently the site of foot injury and pain. Overuse, poorly fitting shoes and structural abnormalities of the feet frequently contribute to the development of conditions that cause heel and foot pain.
Plantar Fasciitis
The plantar fascia is a sheet of fibrous tissue between the ball of the foot and the heel. Irritation and inflammation of this tissue, a condition called plantar fasciitis, is the leading cause of heel pain, reports the American College of Foot and Ankle Surgeons. Factors that increase the risk for plantar fasciitis include obesity, high arches, flat footedness, diabetes and advancing age. Runners and people who stand for much of the day are also at increased risk for plantar fasciitis.
Plantar fasciitis characteristically causes heel pain after sitting for an extended period or when getting out of bed in the morning. Walking stretches the plantar fascia, easing heel pain. Over-the-counter anti-inflammatory medication, steroid injections into the fascia, stretching exercises, shoe inserts that cushion the heel, and wearing shoes with firm arch support often alleviate the pain of plantar fasciitis. For people with severe plantar fasciitis that fails to improve with other forms of treatment, surgery may be advised.
Heel Bursitis
A bursa is a fluid-filled cushion that reduces friction between tendons. Heel pain can arise with inflammation of the heel bursae, a condition known as heel bursitis. Pain and tenderness from heel bursitis occurs at the back or on the underside of the heel, reports the medical information website InteliHealth. In contrast to plantar fasciitis, activity characteristically worsens heel bursitis pain. Risk factors include excessive running or jumping, wearing shoes without adequate cushioning in the heel and an abnormal walking pattern.
Treatment for heel bursitis may include anti-inflammatory medication, application of ice packs to the heel, shoe inserts to cushion the heel, stretching and strengthening exercises for the foot and ankle, and avoiding activities that provoke heel pain.
Stress Fractures
Stress fractures are hairline bone cracks that develop with overuse. Foot bone stress fractures most commonly occur in people who participate in activities that involve repetitive, high-energy stress on the feet. Tired foot muscles fail to absorb the energy of repetitive impacts. The resulting increased tension on the foot bones can lead to stress fractures. Symptoms of foot stress fractures include localized pain, tenderness and bruising at the site of the break. The pain of foot stress fractures worsens with activity and eases with rest.
Stress fractures of the foot most commonly occur in the long bones of the midfoot, the bone at the front of ankle and the heel bone, according to the American Academy of Orthopaedic Surgeons. Treatment for a foot stress fracture depends on the bone involved and the severity of the break.
