Common causes of heel pain when walking are Plantar fasciitis, Bruised heel and Achilles tendon-related injuries. They are usually, but not always overuse injuries which often develop gradually over time. Here we outline the common and not-so-common causes of pain under the heel and at the back of the heel in walkers.
Pain under the heel walking
The follow are common causes of heel pain whilst walking:
Plantar fasciitis is inflammation of the plantar fascia (arch of your foot) at its insertion into the heel. Symptoms consist of pain under the heel which may radiate into the arch of your foot.
Pain is often worse first thing in the morning, or if you have rested it for a period of time. Symptoms go once you have walked around for a bit and your foot has warmed up. However, pain likely returns eventually later in the day, as you walk on it more.
Our step-by-step Plantar fasciitis rehab program is based on reducing pain and inflammation, followed by stretching and strengthening exercises.
A Bruised heel, Policeman’s heel or fat pad contusion causes pain under the heel, similar to Plantar fasciitis. However, key differences are that a Bruised heel is not worse first thing in the morning. In fact, symptoms improve with rest and become worse the more you walk. A Bruised heel is compression and bruising of the shock-absorbing fat pad under your heel.
Treatment involves rest and protecting your heel by wearing gel heel pads or shock absorbing insoles. Taping your heel is a great way of providing instant relief.
Calcaneal stress fracture
A Calcaneal stress fracture is a hairline fracture of the calcaneus (heel bone). It is commonly seen in soldiers, roadrunners, and dancers. Symptoms are similar to a Fat pad contusion with heel pain developing gradually over time. Pain becomes worse with weight-bearing activities like running or jumping.
Pain at the back of the heel walking
The following injuries cause pain at the back of the heel and are common overuse injuries in walkers:
Achilles bursitis or Retrocalcaneal bursitis is inflammation of the bursa (small sac of fluid) at the back of the heel. Symptoms include tenderness and swelling at the back of the heel. The swelling feels ‘spongy’ when pressing it at the sides.
Insertional Achilles tendonitis
Insertional Achilles tendonitis causes pain at the back of the heel, specifically at the point where the Achilles tendon inserts into the heel bone. It is similar to Sever’s disease in children but affects adults.
Other less common causes of heel pain walking
Other causes of heel pain include nerve entrapments such as Medial calcaneal nerve entrapment or Lateral plantar nerve entrapment. These often cause symptoms of burning pain, numbness and pins & needles.
Bone and tissue tumours, Regional complex pain syndrome and Spondyloarthropathies are rare but should not be overlooked.
– like osteoid osteoma, Regional complex pain syndrome and Spondyloarthropathies are rare and are less likely than the above injuries to be causing the pain. If the pain persists then seek medical.
Read more on injuries causing heel pain.