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.
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").
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:
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.
In most cases, heel pain can be relieved without surgery. Treatment may include self-care, medications, therapy or orthotics.
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.