Monday, May 20, 2024
Bottom of Foot Pain FOOT PAIN

Top 5 Reasons Your Heel Hurts From Walking: Heel Pain Causes

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Humans spend the majority of time on their feet. Your feet sustain a tremendous amount of pressure daily. It’s no wonder that so many people struggle with heel pain. If you develop heel pain from walking, you may be wondering what could be causing this and what you can do to treat it.

plantar fasciitis

What Causes Heel Pain in the Feet?

1) Plantar Fasciitis

The plantar fascia is the ligament that is on the bottom of your foot. The plantar fascia originates in the heel and extends into the toes. 

When the plantar fascia becomes inflamed, you may experience heel pain from walking. 

It’s estimated that 7% of patients over the age of 65 have pain in the heel (1), however, it can be seen in people of all ages.

Symptoms of Plantar fasciitis

  • Dull, achy pain in the heel or the arch of the foot

When the plantar fascia is strained and inflamed, you will notice a throbbing ache in your heel or your arch. This tends to become worse the longer you are on your feet.

  • Pain when you stand up from a seated position

When you are seated for a long time, the fascia becomes contracted. When you stand to bear weight on the heel, your fascia becomes strained and will cause pain in your heel. 

  • Pain early in the morning when you get out of bed

This is commonly seen in people who suffer from plantar fasciitis. When you sleep, your feet are more plantarflexed. This means that your toes are pointed in a more downward direction.

This causes both the heel cord on the back of your heels (Achilles tendon) and the plantar fascia on the bottom of your foot to become contracted. When you stand to get up in the morning, you may notice sudden pain in the heels.

With a little movement and walking around, you may notice that the pain reduces.

  • Pain with increased activities

The longer you are on your feet and straining the ligament when it is already inflamed, the worse your symptoms may be. 

  • Gradual increase of pain in the heel for weeks or months

Neglecting to take care of plantar fasciitis early on can cause worsening inflammation of the ligament. 

According to Craig Young’s article2 in the American Association of Family Physicians, plantar fasciitis symptoms can last up to 6-18 months on average. 

  • Swelling in the heel

Anytime there is inflammation in a confined space like the heel, you may notice localized swelling. 

What Can Cause Plantar Fasciitis From Walking

  • Foot structure

If you have a flatfoot or overly high-arch foot, you will be more prone to developing plantar fasciitis. 

When a person is flat-footed, they tend to roll in as they walk. This can cause additional strain on the plantar fascia.

If a person has a foot structure with a very high arch, they may naturally place more pressure on the heel which can cause pain from walking.

  • Shoes

Wearing unsupportive shoes can cause plantar fasciitis symptoms to worsen when walking. If you are walking for long periods wearing shoes that are not appropriately suited for your foot structure, this can cause your heel pain to worsen.

  • Inadequate stretching

Plantar fasciitis occurs from tightening of the fascia as well as tightening of the Achilles tendon. 

The Achilles tendon (heel cord) originates from your calf muscles (Gastrocnemius and Soleus). Not adequately stretching the Achilles tendon and the plantar fascia before walking can cause the heel pain to worsen.

  • Weight gain

Heel pain will occur from walking if you are overweight or have gained weight recently. There is a direct correlation between increased BMI and increased heel pain.

According to a study4 done by Dr. James Rano and Dr. Lawrence Fallat in the Journal of Foot and Ankle Surgery, there is a direct correlation between plantar fasciitis and elevated BMI. 

They suggested that a target BMI of 25 represents a good goal for weight loss to help reduce heel pain. 

Solution

There are many things that you can do to help with discomfort with heel pain that can occur from walking. If you have plantar fasciitis, you should be performing stretching exercises at least three times daily to both the Achilles tendon and the plantar fascia to make sure that the fascia is supple.

You should stretch for 15 minutes at least each time.

You can check out this article on how to appropriately perform stretches for plantar fasciitis. 

You will also want to make sure that you are wearing supportive shoes that are good for your foot structure. 

The best thing you can do is go to a running shoe store or your local foot doctor to have your feet measured and to obtain shoe gear recommendations. This is important if you want to avoid heel pain from walking.

If your doctor believes that your foot structure may be contributing to your heel pain, he/she may suggest over-the-counter orthotics or even custom orthotics to help rebalance your foot structure and relieve heel pain. 

powerstep heel

For arch support, wear the Powerstep Protech insert.

These are great because they have a firm arch support that feels comfortable. Also, the heel cups on the inserts are deep.

The deep heel cup helps stabilize your heels when walking. In addition, the heel has a “poron” component, which helps with shock absorption when you walk.

Depending on how much you walk, these inserts can last anywhere from 6 months to 1 year. You will know when it is time to replace them because the arch will become flat.

Make sure you remove your shoe liners before putting the inserts in your shoes. They work best in athletic shoes.

Performing daily messages to the plantar fascia can help as well. You can obtain a foot massager or you can simply take a tennis ball and roll it across the bottom of your foot to help loosen up the plantar fascia and stimulate blood flow to the area. 

RICE therapy is also recommended for plantar fasciitis. You can ice the heel intermittently, and wrap the heel using an ACE bandage if there is swelling. If you feel excessive pain in the heel, you should rest the heel.  

Your doctor will suggest you wear a night splint at night to hold your ankle in an upwards direction.

By dorsiflexing your ankle when you sleep, both the plantar fascia and the Achilles tendon will be stretched during the night. 

After a while of wearing the splint, you should notice relief of pain in the heel in the morning. 

Wear the United Ortho Night Splint.

It is adjustable, meaning that you can adjust the level of dorsiflexion. You should aim to have at least 10 degrees of dorsiflexion in the ankle when you sleep.

Night splints can be used when sleeping or sitting. You should not walk with the night splint on.

Your doctor may also suggest a steroid injection to help reduce pain and inflammation. 

However, steroid injections do not cure plantar fasciitis. It is used to reduce pain. You will still need to wear appropriate footwear and continue stretching.

Find out more about how effective cortisone injections are in this supplemental article.

Plantar fasciitis Surgery

If all conservative therapy options fail, your doctor may discuss surgical options with you. This would be done via a plantar fasciotomy, where part of the plantar fascia is cut.

What Causes Heel Pain in the Feet?

Heel spurs in the bottom of your heel typically don’t cause pain. Many people who have heel spurs for years on the bottom of their feet don’t even know they have one.

flatfoot

2) A Stress Fracture Can Make Your Heel Hurt

If you have constant heel pain from walking and notice increased pain over time, you may have a stress fracture in the heel. Stress fractures in the heel, unlike acute fractures that can happen due to direct injury, can be difficult to diagnose at times. 

Stress fractures usually start as small hairline fractures that can progress over time. It can be difficult to visualize on x-ray until about 3 to 4 weeks after the onset of pain.

You can read all about foot stress fractures in this separate blog post here

Symptoms of a Stress Fractures in the Heel

Unlike plantar fasciitis, a stress fracture may be painful when walking but may also hurt while resting. You may also notice increased swelling in the heel with bruising.

Solution

If you suspect that you may have developed a stress fracture, it’s important to call your doctor. Your doctor will order an x-ray and may even order an MRI.

If you have a stress fracture, your doctor may suggest you walk in a cast boot for 4 to 6 weeks minimum until the fracture heals. 

This United Ortho short cast boot is great because it stabilizes the foot and ankle appropriately.

The short cast boot is often more comfortable for people to wear than the heavier longer cast boot.

When you return to your activities after healing a stress fracture, you will want to make sure to gradually increase your activities. You may also want to speak to your foot doctor about obtaining custom-made orthotics that could cushion your feet properly.

3) Achilles Tendonitis Can Cause Pain Along the Back of the Heel Bone

If you experience heel pain in the back of your heel bone, you may be suffering from Achilles tendonitis. 

Achilles tendonitis can occur due to inflammation of the insertion of the Achilles tendon (heel cord) that attaches to the back of your heel.

Some of the causes of Achilles tendonitis include:

  • Tight Achilles tendon

In some people, the Achilles tendon becomes extremely tight. This tightness in the tendon can cause achy pain to occur in the back of the heel when walking due to the pulling of the tendon that occurs from walking. 

Tightening of the Achilles tendon in the back of the heel can cause heel spurs to form in the back of the heel. 

Unlike heel spurs in the bottom of the heels, these heels spurs can be painful.

  • Overuse

If you increase your activities too soon you may experience an achy pain in the back of the heel from walking. The Achilles tendon can get fatigued and inflamed due to overuse.

  • Low riding shoes

Certain shoes that have a low back to them can cause irritation and discomfort in the back of the heel when walking (3)

Read more about how Bad Shoes Can Affect Foot Pain here.

Symptoms of Achilles Tendonitis

  • Dull, achy pain in the back of the heel

If you are experiencing Achilles tendonitis you may notice dull and achy pain in the back of your heel. You may also notice swelling in the back of your heel. This is due to inflammation of the tendon. 

  • Burning pain in the back of the heel

If you suffer from Achilles tendonitis, you may experience burning pain in the back of the heel from walking. 

This can occur due to inflammation at the insertion of the Achilles tendon and the nerves that traverse next to the tendon. 

If there’s inflammation in the tendon, the nerves may be aggravated and this can cause burning pain.

Solution

It’s important to perform Achilles tendon stretching exercises before and after walking. It’s also important to make sure that you are wearing well-fitted shoes and orthotics.

Obtaining heel cups such as Tuli’s heel cups can help to cushion your heel when walking and reduce shock absorption. 

The added cushion can help a lot to relieve pain in the heel when walking. You can order your size, and place them in your shoes.

Heel lifts can also be beneficial to wear in your shoes to alleviate tension along the Achilles tendon. The heel lift elevates the heel when walking. 

This will shorten the Achilles tendon and prevent straining of the tendon. This can help to reduce pain.

Pro tip: Make sure you start with a 1/8″ heel lift. Using a lift that is too large can cause pain in your knees, back, and hips. Once you get used to the 1/8″ heel lift, you can discuss with your doctor whether you may benefit from a larger lift.

If the pain in the back of your heel is significant, your doctor may suggest physical therapy to help reduce pain and strengthen the tendon. 

Ultrasound can also help to reduce inflammation of the Achilles tendon. 

You can also wear a night splint to stretch out your Achilles tendon when sleeping. 

stretching achilles

4) Haglund’s Deformity

You may be naturally born with a bony prominence on the back of your heel. This is called Haglund’s deformity. 

Usually, this is not symptomatic, unless, of course, you suffer from Achilles tendonitis. 

However, if you experience pain from walking in the area of your Haglund’s bump, it could be your shoes that are aggravating the back of your heel.

Symptoms

  • Swelling in the back of the heel
  • Dull, achy pain in the back of the heel
  • Pain that worsens with activity

Solution 

If you notice increased pain with swelling in the back of your heel, you should try to avoid shoes that rub and irritate the back of your heel. 

Heel cups that cushion the heel will also help. Occasionally, surgery may be performed to shave away the bump. 

5) Baxter’s Neuritis 

If you experience sharp or stabbing heel pain from walking, it could be Baxter’s neuritis. 

The lateral plantar nerve that passes through the heel “Baxter’s nerve” can become entrapped. 

Certain foot structures, likely excessively flat feet, can cause impingement of the nerve and cause pain. 

It’s also been suggested that Baxter’s neuritis is more commonly seen in patients who suffer from plantar fasciitis (5).

Read the Ultimate Guide To Nerve Pain In The Foot here.

Symptoms

  • Pins and needles sensations in the heel
  • Swelling with sharp pain in the heel
  • Burning sensation in the heel

Solution

Baxter’s neuritis symptoms will be improved with appropriate orthotics as well as heel cups that can help cushion the heel. 

Ultrasound therapy will also help to reduce pain. In addition, steroid injections will help reduce nerve pain in the affected heel as well. 

Best Shoes for Baxter’s Nerve Entrapment

The best shoes for Baxter’s nerve entrapment should provide adequate support and cushioning to alleviate pressure on the heel and prevent irritation of the nerves. 

Shoes with good arch support and shock-absorbing soles can help distribute weight evenly and minimize impact on the heel. It is essential to find shoes that fit properly and don’t rub or irritate the heel area. 

What Health Treatments Can Prevent Heel Pain?

Maintaining a healthy weight and engaging in regular exercise can help reduce stress on the feet and prevent conditions like plantar fasciitis. 

Wearing appropriate footwear that provides proper arch support and cushioning is crucial for preventing heel pain. By understanding the causes of heel pain and implementing preventive measures, you can take proactive steps to keep your feet healthy and pain-free. 

For more information and detailed advice on specific health conditions, continue reading articles written by healthcare professionals and medically reviewed sources.

Conclusion 

Walking with heel pain can be so uncomfortable. It can be frustrating because it willcause you to limit your activities for a while. It’s important to figure out what exactly is causing your heel pain from walking and follow up with your doctor sooner than later so that the heel pain doesn’t get worse.

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heel pain pin

References

  1. S Cutts, N Obi, C Pasapula, and W Chan. The Annals of The Royal College of Surgeons of England 2012 94:8, 539-542. https://publishing.rcseng.ac.uk/action/showCitFormats?doi=10.1308%2F003588412X1317122159245
  2. Young CC, Rutherford DS, Niedfeldt MW. Treatment of plantar fasciitis. Am Fam Physician. 2001 Feb 1;63(3):467-74, 477-8. Erratum in: Am Fam Physician 2001 Aug 15;64(4):570. PMID: 11272297. https://pubmed.ncbi.nlm.nih.gov/11272297/
  3. Mazzone MF, McCue T. Common conditions of the Achilles tendon. Am Fam Physician. 2002 May 1;65(9):1805-10. PMID: 12018803. https://www.aafp.org/pubs/afp/issues/2002/0501/p1805.html
  4. Rano J, Fallat L, Ruth T. Savoy-Moore. 2001. Correlation of heel pain with body mass index and other characteristics of heel pain. The Journal of Foot and Ankle Surgery. Vol 40 (6). 351-356. https://www.sciencedirect.com/science/article/abs/pii/S1067251601800028
  5. Del Toro, D. R. (2004). Baxter’s Nerve Entrapment. Painful Foot and Ankle, 9. http://www.aanem.org/mxonline/resources/downloads/products/2004CourseC.pdf#page=16

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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