Relief for Painful, Inflamed Heels
Sharp pain, aching or stiffness on the bottom of one or both heels is a very common ailment. The pain is often at its worst upon awakening in the morning (or after sitting down for an extended period and then resuming activity), causing hobbling or limping for a few minutes before a comfortable stride can be resumed. As weight continues to be applied during walking or standing, mild or severe pain may persist.


Causes of Heel Pain
inflamed heels, foot heel problems, foot heel nerve problems, swollen feet causes Heel pain originates deep within the foot, directly on the heel bone or within the foot's connective tissues, called the fascia.

Several layers of fatty tissue surround the heel bone, softening the impact of walking and running and protecting the bones and muscles of the foot. Beneath this padding, a tissue (the fascia) extends from the heel bone, supports the arch and reaches across to the toes. Pain can result when these tissues become irritated or inflamed, or when small spurs grow on the heel bone.


Most cases of heel pain are characterized by inflammation. First, the fascia begin to pull on the bone and the tissues becomes irritated, then inflamed. Inflammation of the fascia is called fasciitis.


Heel Spurs
A projection or bone growth may be called a spur, and can grow where the muscles of the foot attach to bone. While some heel spurs are painless, others that are determined to be the cause of chronic heel pain may require medical treatment or surgical removal (see "Surgical Treatments for Heel Pain").


Other Causes
While injury, overuse or other temporary, mechanical causes can bring on discomfort in the heel, a painful heel may also accompany a more serious condition, such as:

bulletCollagen disorders
bulletNerve injuries
bulletHeel bone abnormalities


Illnesses like these and others must be diagnosed and treated separately. Your podiatric surgeon may refer you to a local specialist if the problems are beyond his or her area of expertise.

Caring for the Painful Heel
In most cases, heel pain can be relieved without surgery. Treatment may include self-care, medications, therapy or orthotics.


Several steps can be taken to care for a painful heel at home.

bullet Take medications that contain ibuprofen or aspirin daily as directed, for as long as symptoms persist, to help reduce tissue inflammation. Follow dosage directions carefully. As with any medication, be aware of potential allergic responses and discontinue use if any adverse reaction occurs, or if pain is not relieved after several days' use.
bullet Soak the heel in ice water to relieve pain and inflammation. This works best by placing the foot In a basin filled with tap water, high enough to cover the heel. Allow the foot to adjust to this temperature. Then add ice cubes (two or three at a time) every five or six minutes over a 30-minute period. Soak the foot in ice water three times daily and immediately after any activity. Heat may also be recommended, but ice is usually preferable. Caution: People with diabetes or poor circulation should not use cold water or ice packs.
bullet Avoid sports and other vigorous activities while healing.
bullet Wear higher heeled shoes and choose shoes with heels made from soft rubber instead of leather. Running shoes are often the most comfortable.
bullet Stretch the calf muscles daily.

Nonsurgical Medical Treatment
If self-care measures do not relieve the pain, the podiatric surgeon may recommend various treatments to reduce inflammation. Some of these may include:

bullet Prescription oral nonsteroidal anti-inflammatory medications to reduce both pain and inflammation.
bullet Cortisone injections
bullet Foot taping and padding
bullet Physical therapy - The podiatrist or physical therapist may treat heel pain with ultrasound, electrical stimulation or hydrotherapy. Each of these methods may help reduce inflammation.
bullet Custom orthotics - A foam or plastic orthotic (custom-made to fit the foot) can often relieve the strain on the tissues and permit the heel to recover.

Surgical Treatments for Heel Pain
If nonsurgical medical treatments fail and pain persists, surgical intervention may be necessary. Both surgical procedures described below are usually completed on an outpatient basis in less than one hour. They are performed comfortably under either local anesthesia or minimal sedation administered by trained personnel.


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