Heel pain can have many causes. If your heel hurts, see your foot and ankle specialist right away to determine why and get treatment. Tell him or her exactly where you have pain and how long you've had it. Your doctor will examine your heel, looking and feeling for signs of tenderness and swelling. You may be asked to walk, stand on one foot or do other physical tests that help your doctor pinpoint the cause of your sore heel. Conditions that cause heel pain generally fall into two main categories: pain beneath the heel and pain behind the heel.
If your first few steps out of bed in the morning cause severe pain in the heel of your foot, you may have plantar fasciitis (fashee-EYE-tiss), an overuse injury that affects the sole of the foot. A diagnosis of plantar fasciitis means you have inflamed the tough, fibrous band of tissue (fascia) connecting your heel bone to the base of your toes.
You're more likely to develop the condition if you're female, overweight or have a job that requires a lot of walking or standing on hard surfaces. You're also at risk if you walk or run for exercise, especially if you have tight calf muscles that limit how far you can flex your ankles. People with very flat feet or very high arches also are more prone to plantar fasciitis.
The condition typically starts gradually with mild pain at the heel bone often referred to as a stone bruise. You're more likely to feel it after (not during) exercise. The pain classically occurs right after getting up in the morning and after a period of sitting.
If you don't treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity, and you may develop symptoms of foot, knee, hip and back problems because plantar fasciitis can change the way you walk.
If you look at an adult foot from the inside, you'll usually notice an upward curve in the middle. This is called an arch. Tendons -- tight bands that attach at the heel and foot bones -- form the arch. Several tendons in your foot and lower leg work together to form the arches in your foot. When the tendons all pull the proper amount, then your foot forms a moderate, normal arch. When tendons do not pull together properly, there is little or no arch. This is called flat foot or fallen arch.
Many young children have flat feet, a condition referred to as flexible flat feet. When the child stands, the feet look flat. But when the child rises to his or her toes, a slight arch appears. In most cases, as children grow older, the arches develop.
Causes of Flat Feet and Fallen Arches
Flat feet in adults can arise from a variety of causes. Here are the most common:
- An abnormality that is present from birth
- Stretched or torn tendons
- Damage or inflammation of the posterior tibial tendon (PTT), which connects from your lower leg, along your ankle, to the middle of the arch
- Broken or dislocated bones
- Some health conditions, such as rheumatoid arthritis
- Nerve problems
Other factors that can increase your risk include:
Symptoms of Flat Feet and Fallen Arches
Many people have flat feet -- and notice no problems and require no treatment. But others may experience the following symptoms:
- Feet tire easily
- Painful or achy feet, especially in the areas of the arches and heels
- The inside bottom of your feet become swollen
- Foot movement, such as standing on your toes, is difficult
- Back and leg pain