What are the most common forms of heel pain?

Heel pain (also called talalgia) is one of the most common foot problems that podiatrists treat on a daily basis. In fact, no one is entirely immune to suffering from some form of talalgia during their lifetime.  

Affecting Quebecers of all ages and backgrounds, heel pain can come in many different forms. Symptoms, causes and pain level often vary from case to case.

This pain can be caused by:

  • poor foot positioning
  • a fall
  • a bone fracture
  • poor running techniques
  • lesions
  • flat or hollow feet
  • flattening of the plantar arch
  • age
  • health issues, such as obesity or diabetes

It is very important to consult a professional as soon as initial pain is felt, no matter how benign. This will ensure you prevent the pain in your heel from getting worse. To help you prevent any possible foot pain, it is important to recognize some early warning signs.

There are 8 main forms of heel pain. Can you guess what they are?

Plantar fasciitis

Plantar fasciitis (or plantar aponeurosis) is undoubtedly one of the most common forms of foot pain. Thus, all podiatrists will necessarily have to treat many cases of plantar fasciitis during their career.

The main symptom of plantar aponeurosis is the occurrence of pain in the heel area, of severe to moderate intensity, often occurring soon after getting out of bed or after sitting for a long period of time. Although the pain usually disappears as the day progresses, the situation should not be taken lightly!

Plantar fasciitis pain affects your daily life and is caused by trauma to the plantar fascia (also called plantar aponeurosis), a membrane that attaches to the heel and supports the arch of your foot. This inflammation of the fascia causes pain in the heel, which can take the form of tingling, a sharp pinching or a burning sensation.

No one is entirely immune to plantar fasciitis, but some individuals are more at risk than others:

  • runners or other athletes
  • seniors
  • those who work in physically demanding jobs
  • obese persons
  • people with flat or hollow feet
  • those who walk barefoot too often

Repetitive foot movement, shoes that do not properly support the foot, or insufficient warm-up before physical activity are among the most common causes of plantar fasciitis. Learn to recognize the symptoms in order to avoid any potential inconveniences.

Heel spurs

Heel spurs, also called calcaneal spurs, are a heel injury in the form of a small bone growth in the heel bone, usually due to a calcium deposit in the plantar fascia.

This condition is often confused with plantar fasciitis, due to the fact that this bone excrescence affects the plantar fascia as well! That’s because the symptoms for both these conditions are similar in nature. In addition, the heel spur may be caused by fasciitis that has remained untreated for too long. Thus, it can be said that these two conditions are sometimes interrelated.

Persons primarily affected by heel spurs include:

  • women aged 40 or older
  • people experiencing a loss of flexibility
  • those who remain standing for long periods of time
  • people who wear improper or ill-fitting footwear
  • those suffering from arthritis
  • obese individuals

While the calcaneal spur is not always painful and can sometimes even be beneficial to your foot by strengthening it, this growth can be problematic and cause pain in some cases, especially when the plantar fascia is overworked. This is the reason you should consult a podiatrist if you are in doubt.

Although heel spurs are a rather unobtrusive condition, they can be detected by X-ray.   

Achilles tendonitis

Achilles tendonitis often appears following physical effort. This pain is caused by an inflammation of the Achilles tendon, which serves to flex your ankle and support the joints of your foot.  

As we get older, many of us lose our flexibility. As a result, the tendon loses its elasticity, which can cause inflammation in the lower calf. That’s why joggers must be extra vigilant to ensure that they develop a good running routine and not exceed their limits.

Achilles tendonitis can take two distinct forms, which can be interrelated:  

  1. Degenerative tendonitis (or degenerative tendinopathy): this is caused by a lack of tendon elasticity, which will weaken with age.
  2. Acute tendonitis: this occurs when the tendon is overworked during intense physical exertion.

There are several causes that can lead to this condition affecting your daily life:

  • poor hydration while playing sports
  • insufficient warm-up before a race
  • insufficient stretching following a sports activity
  • excessive repetitive movements
  • training on too hard a surface
  • flat or hollow feet

If you feel pain in the morning when you wake up or following sustained effort, or if you have begun to limp frequently, you may be suffering from tendonitis in the Achilles tendon. Keep a close watch on your symptoms and consult a professional if in doubt.  

Heel bursitis

Heel bursitis, also called calcaneal bursitis, is caused by an inflammation of the bursa, located in the posterior portion of the heel. It is a cavity containing the fluid required to lubricate the tendons of the foot. Inflammation of the bursa causes pressure in the heel, resulting in pain.

This condition often takes the form of redness, swelling or stiffness in the heel. It is usually caused by wearing high heels or shoes that are too tight. However, other factors may also be involved.

There are several causes that can lead to bursitis:

  • Overexertion or repeated movements often cause this type of pain.
  • A foot injury or trauma can cause bruising to the bones of the foot and trigger pain.
  • Various forms of rheumatism can also cause calcaneal bursitis.

To prevent this type of pain, it is especially important to avoid rubbing your tendons while playing sports or walking.

Before treating your bursitis, the podiatrist will first ensure that it is not tendonitis. In fact, these two foot conditions have similar symptoms, but do not affect the same region and thus cannot be treated in the same manner. Only your foot professional can distinguish among them and treat these two separate conditions. We can’t all be experts!

Heel panniculitis

Heel panniculitis is an inflammatory skin disease. This inflammatory lesion affects the panniculus, a layer of fatty tissue located under the epidermis of the skin. In addition to the heel, this disease can also affect other cutaneous regions.  

This inflammation results in the appearance of nodules, an abnormal thickness of the skin, often in the shape of small balls. These nodules are usually caused by microlesions of the superficial fascia of the skin. It goes without saying that panniculitis in the heel area causes pain and severely hinders your movements!

This condition can appear as a result of:

  • repeated rubbing of the heel
  • temperature that is too hot or cold
  • excessive pressure on the heel
  • direct trauma to the region

Thus, if you notice what you think are sensitive nodules appearing in the region of your heel, you should consult a professional without delay.

Sever’s disease

Sever’s disease, also called calcaneal apophysitis, is a condition that usually occurs at the end of heel growth between the ages of 10 and 14. This disease only affects active children and adolescents, often during the puberty stage.

Because the foot bones and tendons of children in their growth stage are not fully developed, there is a possibility that the numerous foot cartilages may be weakened following physical activity. And since the heel bone does not always grow at the same rate as the rest of the leg, discomfort can occur.

As a parent, you must keep a sharp lookout for signs from your children to try to prevent Sever’s disease. In particular, this condition affects:

  • children who take part in running sports, like soccer
  • young gymnasts and dancers
  • youth who have just started playing a new sport

In addition, if your child limps or walks on the tips of their toes, this is generally a good indication they are suffering from this type of pain.

This condition is not always painful, but it can eventually become painful if not treated. After a lengthy period of time, this inflammation can cause bruises or bone fractures. That’s why it is important to intervene promptly if your child complains of pain in the heel region or Achilles tendon area.

Heel fissures

Heel fissures occur when your foot’s skin becomes extremely dry and eventually cracks. Since the heel supports the full weight of your body on a daily basis, it can sometimes crack if it is not sufficiently hydrated.

These cracks take the form of fissures, which can have different levels of depth. These cracks often harden the skin of your foot and give it an unusual color.

In addition to being unsightly, heel fissures often cause itching, redness and pain. Fortunately, there are several ways to prevent them:

  • by properly hydrating your feet (a variety of moisturizing creams or oils can help improve this condition)
  • by wearing shoes that provide proper support for your feet (avoid wearing flip-flops or other types of sandals as much as possible)
  • by removing dead skin with a pumice stone designed for feet

If your heel fissures are not painful, the tips mentioned above will alleviate this problem. However, if the level of discomfort becomes more pronounced, you should consult a professional without delay to ensure they don’t become infected!

Heel fractures

Heel fractures, also called “Lover’s fracture,” appears at the calcaneal bone, located at the back of the foot. While these fractures are not common, the associated consequences can be serious. They can cause more serious health issues, including arthrosis of the ankle, among others.

This type of pain, which is very debilitating to your daily life, often appears as a swelling and bruising of the foot. It occurs following a very violent shock, such as a heavy fall.

Pay attention to the signals your body sends you in order to quickly treat heel fractures and prevent them from getting worse. Here are some symptoms to watch for:

  • difficulty supporting your body’s weight
  • foot swelling
  • a recent accident to the foot
  • osteoporosis

Men aged 35 and older are those most affected by heel fractures. Depending on the seriousness of the fracture, the knees and vertebrae can also be affected. This condition is also found among runners experiencing muscle fatigue. Diabetics are also more vulnerable. This problem should never be taken lightly!

PiedRéseau, the standard when it comes to treating heel pain

As you have just learned, talalgia takes many forms and can be caused by many factors. Podiatrists are the most competent professionals to properly treat your pain.

Consult a PiedRéseau clinic near you for answers to all your questions and concerns regarding the health of your heels. A foot expert is on hand throughout Quebec to help you manage your condition without delay.