Other Causes of Heel Pain (but not Plantar Fasciitis)

 

While plantar fasciitis and heel spur syndrome are the most common causes of heel pain they are not the only causes, and the following list outlines the lesser know underlying conditions behind this type of discomfort:

Sciatica

If the sciatic nerve gets pinched it can cause foot pain. While the compression generally occurs in the lower back it’s not unusual for the pain to travel into the heels, as this is where the sciatic nerve ends. When this occurs it is called ‘referred pain’. Treatments for sciatica are not the same as they are for plantar fasciitis.

Arthritis

Arthritis is an inflammatory disease that can affect various parts of the body, and unfortunately, the feet are not immune. If there is pre-existing arthritis in the body and heel pain is found in both feet then arthritis becomes a more likely candidate for being the source of discomfort.

Tendonitis

Inflammation of the Achilles tendon is a major cause of heel pain and is often the next best guess if plantar fasciitis and heel spurs have been ruled out. Treating tendonitis is very similar to treating plantar fasciitis as it includes rest, icing the afflicted area, and using anti-inflammatories to reduce severe irritation.

Long Plantar Ligament Injury

When the ‘long ligament’ is injured it causes pain in the heels and feet but in this case the affected area will not be tender to the touch because the damage will have occurred too deeply in the foot. Long plantar ligament injury is given the same treatments as plantar fasciitis, except when it comes to surgery, as the ‘release’ technique used for plantar fasciitis will only make a ‘long ligament’ injury worse.

Stress Fracture

Stress fractures are far more prevalent in flat feet than properly arched feet and it is not always clear that a fracture has occurred. Many of the treatments used for a fracture are similar to the treatments used for plantar fasciitis, however, one large difference is that medical treatment should be sought for a fracture as further damage (such as a complete break) can occur if the foot is not protected and immobilized.

Tarsal Tunnel Syndrome

When carpal tunnel syndrome occurs in the foot it is referred to as tarsal tunnel syndrome. This tunnel is made of ligaments and bones, and it is filled with the tendons and nerves threading their way through it. When these tendons are inflamed it’s very painful, but this inflammation also puts a lot of pressure on the surrounding nerves, which can cause significant discomfort in the underside and heel of the foot. Numbness and/or a tingling sensation are quite common occurrences as well. Tarsal tunnel syndrome can be treated through the introduction of an arch support, a cortisone injection in the foot, or if all else fails, surgery.

Diminished Heel Pad Tissue

As we age we often lose volume in the tissue of our heel pads; this kind of discomfort most often occurs in elderly patients. Inserting high quality orthotics with sufficient padding into the shoe to support the foot and lessen the impact of walking usually gives great results.

Bursitis of the Heel

When the jelly-like sac that protects the heel bone from irritation and injury becomes inflamed it usually indicates that the sufferer has unusually thin tissue in the heel area. While bursitis of the heel can be caused by plantar fasciitis, it is very seldom heard of.  The treatments for both conditions is nearly identical, but while surgery may be an option for this type of injury cortisone injections usually are not because they can rupture the plantar fascia.

Sever’s disease

Sever’s disease carries many of the same symptoms that plantar fasciitis does but plantar fasciitis is rarely seen in people younger than 25 years of age. When active children between the ages of 8-12 years old shows symptoms of plantar fasciitis it is almost always certainly a case of  Sever’s disease, which is caused by a combination of high activity levels and a still developing heel bone.

Sacral Radiculopathy Nerve Compression

When this particular nerve becomes trapped it can produce symptoms that are very similar to plantar fasciitis as well as numbness, tingling, and a sensation of weakness along the nerve right into the foot. Treatment for this affliction is not the same as the treatments used for plantar fasciitis; it often includes physiotherapy, medication, and manipulation of the spine.

Tibialis Posterior Tendonitis

When the posterior tibial tendon is inflamed or torn it no longer adequately supports the arches in the feet. Flatfoot—and the accompanying pain that usually results from this condition—is imminent. The treatment for tibialis posterior tendonitis may include the use of braces and orthotics.

Excessive Standing

Standing on your feet for most of the day can cause heel pain, especially if it you do it on a daily, or almost daily, basis.  If you are unable to reduce the amount of time you spend on your feet you should try using orthotic inserts to ensure that you have sufficient cushioning and support for your feet.

If you are a few pounds heavier than you should be then shedding that weight will give you great results as well. Be sure to stretch your calf muscles regularly. Rubber mats placed at your primary work station should provide enough cushioning to relieve you of the worst of your heel pain.

Body Weight and Plantar Fasciitis

Studies show that being overweight is a primary cause of foot and heel pain; in fact, if you’re are overweight you are five and half times more likely to experience pain than people at a healthier (non-obese) weight.

Women are more likely than men to gain weight below the hips, and this in turn lowers the centre of gravity, a condition that negatively affects how pressure is distributed—or rather not distributed—throughout the foot. Having a lower centre of gravity requires increased flexibility in the calf muscles as well, so a sudden increase in fat deposits may cause discomfort as it takes time for the body to adjust to counter-balancing this new weight.

People with heel pain have a much shorter life expectancy than those who do not simply because this type of discomfort is so intimately tied with being overweight and the satellite illnesses (stroke, diabetes, heart disease, etc.) that usually occur under these circumstances.

A Final Word

Plantar fasciitis and heel spur syndrome are the two most common underlying conditions behind foot and heel pain, but they are by no means the only underlying conditions that can be causing this type of discomfort. And some of the other causes—such as being overweight—are much more dangerous to your health than an inflamed plantar fascia, and it’s important to be aware of that.

Fortunately, no matter what the source of your heel pain is a few critical lifestyle changes will go a long way to lessening your discomfort and to preventing the condition from occurring again in the future.

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