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Heel Pain

Haglund’s Deformity

Haglund’s deformity is a specific type of calcaneus (heel bone) spur. The spur can rub against the Achilles tendon and cause pain swelling, create a painful bursa, and damage to the Achilles tendon. This is a hereditary condition. Treatments often include heel lifts to reduce tension on the Achilles tendon and change the position of the prominence, therapy and stretching. Surgery is sometimes required to remove the spur but is rare.

Plantar Fasciitis

Plantar fasciitis is an extremely common cause of heel pain. There is a band of tissue across the bottom of the foot which becomes inflamed. This extends from the heel to the toes and is part of the structures which holds up the arch of the foot. This can happen without injury. Prolonged standing at work, use of ladders, weight, and repetitive activities are some of the risks for this condition. Spurring of the heel is very common but is not usually the origin of pain. Symptoms include pain (especially with the first step after sleep or rest), difficulty walking. Pain usually consists of a sharp or tearing sensation. This can cause pain which radiates to the arch or back of the leg. There is occasionally swelling. X-rays are usually required to aid in diagnosis. Ultrasound can also be helpful. Treatments include stretching, icing, massage, orthotics, stretching devices, physical therapy, and injections. Surgery is sometimes required to reduce scarring or tension in the plantar fascia. It is very rare to require removal of any bone spurring.

Heel Fissures

Heel fissures is also known as cracking of the skin at the heels. This can be quite painful and cause redness, swelling, and bleeding. There are some inflammatory skin conditions which can cause this probem. Generally this is not the case. Fissures are common during the summer months as open backed sandals allow the heel to slip back and forth causing the skin to crack. Other conditions such as eczema and psoriasis can also contribute to the problem. Those prone to dry skin of the feet are also at risk.

Pediatric Heel Pain

Severs is a common condition in which there is pain and inflammation of the heel in children approximately 8–14 years old. This is most common in kids who participate in sports and can be quite severe. There are several other areas of the foot and leg in which this can occur. Parents may notice a decreased interest in activities due to the pain. They may also begin to walk strangely. Treatment includes Rest, ice, avoidance of sports, walking boots, physical therapy. X-ray of both feet may be necessary to compare for symmetry. Occasionally an MRI is needed as the growth plates (physis) are not easily visible on standard x-ray.