The heel is the part of the foot that receives the most pressure from daily activities like walking and standing. In addition, sometimes tiny bony deposits or calcifications can form along the edge of the heel bone where they can irritate soft tissues or press into the plantar fascia, a strong band of tissue that extends across the bottom of the foot, supporting the arch and enhancing flexibility and mobility. Heel pain can also occur when the plantar fascia becomes stiff and inflamed as a result of repeated pressure or simply as a result of age-related changes in the tissues, causing a common condition called plantar fasciitis. Sometimes, deep bruises (sometimes called “stone” bruises) can form in the heel, resulting in tenderness and pain. Other causes of heel pain include Achilles tendonitis, arthritis and heel bursitis.
Bursa are small sacs of fluid that help prevent friction in joints. In the heel, the retrocalcaneal bursa is located near the back of the heel where the Achille's tendon attaches to the foot. Gentle stretching exercises sometimes accompanied by cortisone injections can help relieve irritation and inflammation.
The first step in treating heel pain is diagnosing the cause. A physical examination of the heel and foot including active and passive exercises and gentle palpation can help pinpoint the source of painful symptoms. Sometimes, diagnostic imaging may be used to obtain additional information that can pinpoint the source. Once the cause is determined, treatment options can include:
Losing excess weight can also help by reducing pressure on the heel and the surrounding tissues.
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