Suggested ORF Modifications
ICD 10 - M77.3
The foot handles a lot of forces during walking and physical activity. Some of the highest forces in the foot are at the heel due to impact with the ground. A lot of repetitive stress can wear down the tissues in the foot and cause heel problems. Heel pain will usually heal on its own, but if the repetitive stress is unchecked, the condition can become problematic and chronic.
If pain at the heel is located in the more bottom aspect of the heel, the condition is likely to be one of three things:
- Stone bruise: The bruising of the underside of the fat pad due to stepping on a hard object.
- Plantar Fasciitis: The inflammation of the fascia in the foot usually is first felt at the heel and flares up during physical activity. See the section on Plantar Fasciitis to learn more.
- Heel Spur: Due to chronic inflammation and chronic wear, a calcium deposit or bone spur can occur around the heel bone which often irritates other nearby tissue.
- Pain on the bottom of the heel
- Pain in the arch
- Pain that increases during physical activity
- Swelling, redness and discoloration of the heel
To determine the condition and cause, the clinician will look at the patient’s past medical history, examine the foot and is likely to order X-rays to determine the cause and severity of the heel pain.
Mild and acute heel pain can often be treated with proper stretching, ice, rest and NSAIDs. Persistent heel pain that lasts for more than a few weeks can still be treated conservatively with padding, taping, orthotics and physical therapy. A night splint and a walking cast or brace may be necessary if the condition is severe enough. Surgery is not usually necessary for most conditions causing heel pain, but may be depending on the severity of the condition and willingness of the patient.