What causes pain in the heel?

Pain in the heel can be caused by many things. The commonest cause is plantar fasciitis. Other causes include:

• being overweight
• constantly being on your feet, especially on a hard surface like concrete and wearing hard-soled footwear
• thinning or weakness of the fat pads of the heel
• arthritis in the ankle or heel (subtalar) joint
• irritation of the nerves on the inner or outer sides of the heel
• fracture of the heel bone (calcaneum)

What is plantar fasciitis?

The function of the heel in walking is to absorb the shock of your foot striking the ground and to start springing you forward on the next step. The heel bone, or calcaneum, is cushioned by specialised fat, contained in elastic pockets, within the thickened skin of the heel. It contains a strong bone (the calcaneum).

I’ve been told my pain is caused by a bone spur. Is this likely?

Near the inflamed plantar fascia attachment, but not in it, some extra bone may form, producing a small ‘spur’. In fact, it is a shelf of bone, not a sharp spur. These ‘heel spurs’ are commoner in people with plantar fasciitis, but they can be found in people with no heel pain. The heel spur is caused by the same process as the heel pain, but the spur is not itself the cause of the pain.

Can I do anything about heel pain myself?

You can try to avoid the things that cause heel pain to start:

• Lose weight
• Where your job allows, minimise the shock to your feet from constant pounding on hard surfaces, both by reducing the time you spend on your feet, and wearing shoes with a soft, cushioned heel (such as training shoes).
• Reduce the shocks on your heel by choosing footwear with some padding or shock-absorbing material in the heel. Heel pads can be bought in most chemists. These pads can be put in standard shoes to reduce the impact of walking.
• If you have an injury to your ankle or foot, make sure you exercise afterwards to get back as much movement as possible to reduce the stresses on your foot and your heel in particular

If you start to get heel pain, doing the above things may enable the natural healing process to get underway and the pain to improve.