Twenty-five percent of the bones in our body are located in our feet, so when something feels wrong there it can throw everything off. Heel pain in particular can be problematic as it forces us to rock forward on the more delicate bones of our toes, causing imbalances that travel up the body. Treatment for heel pain can help bring balance back into the body. Here are some common causes of heel pain and 28 of our favorite heel pain treatments.
What causes pain in the heel of the foot?
In addition to the 26 bones found in each foot, there are 33 joints and 100 tendons in the entire foot and ankle. The largest bony structure in this area is the heel bone. We take this sturdy bone for granted until heel pain gives us pause.
As we’ll discuss in more detail, the most common heel pain causes include:
- Plantar fasciitis
- Heel spurs
- Achilles tendonitis
Plantar fasciitis is an inflammation of the plantar fascia, the connective tissue that runs from the heel bone to the tip of the foot. This is a common running injury that occurs when the tendon is overstretched.
Without appropriate heel pain treatments, plantar fasciitis may progress into heel spurs.
A heel spur is a bony growth that results when the connective tissue of the foot begins to disintegrate as plantar fasciitis worsens, allowing calcium to build up in the heel. Heel spurs feel like a pin is stabbing into the foot every time weight is put on it, a sensation that can quickly escalate from minor annoyance to major pain.
Achilles heel pain is located more at the back of the heel but is considered a crucial type of heel pain. This tendon, when injured or inflamed, can severely reduce mobility and cause pain that can be more challenging to treat.
Bursitis is an inflammation of the bursae, the fluid-filled sacs that surround the joints. With 33 joints in the feet, the pain that results from this condition can be excruciating and persistent, even during sleep.
Our feet provide the support and shock absorption for our body weight for our whole lives.
Over time and depending on many factors like activity levels and weight, this pressure can cause wear-and-tear forms of arthritis likes osteoarthritis and inflammatory conditions like ankylosing spondylitis. An astonishing 50% of people in their 50s and 60s experience some form of heel and ankle-related arthritis pain.
How do I fix the pain in my heel?
Most heel pain, whether it is back of heel pain or pain radiating across the bottom of the foot, needs a layered and comprehensive approach to treatment.
Initially, rest is recommended, along with over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. After this initial period of rest, it’s important to take active steps to reduce the pain, strengthen your foot overall, and prevent further damage.
Heel pain treatments may include:
- Home remedies like icing or stretching
- Heel exercises
- Visiting a physical therapist for advanced rehabilitation
- Interventional procedures, like radiofrequency ablation or injections
- Surgery for severe cases
Home remedies for heel pain
Home remedies for heel pain are a first-line, minimally-invasive way to relieve pain in the heel and prevent further damage. Here are six of our favorite home remedies. Always talk to your doctor before attempting any of these heel pain treatments at home, to ensure you don’t exacerbate an underlying issue.
1. Cold rolling
Freeze a water-filled plastic bottle and roll the affected foot over it for 20 minutes three or four times a day.
2. Foot massage, part 1
Use your thumbs to apply pressure from the heel of the foot to the ball of the foot at the base of the toes, up through the center of the foot.
3. Foot massage, part 2
Flex your foot strongly and use the knuckles of your hand to run up and down the inside arch of the foot. This can be quite painful. Go slowly and pause in areas that are painful. Place slow, steady pressure and breathing into the sensation.
4. Tennis ball massage
Place your heel on the ground and a tennis ball underneath the ball of your foot. Gradually bring your weight forward onto the tennis ball. Hold for 30 seconds. Try to keep your toes from gripping the ball. Move the tennis ball to your heel and place the ball of your foot on the ground. Gradually bring weight into the ball of your foot. Hold for 30 seconds.
5. Foot soak
Use Epsom or arnica salts in heavy concentration and soak your foot in a warm bath.
6. Foot wrap
Soak gauze in warm linseed oil and wrap around your heel.
Heel pain treatment exercises
Once the period of rest has passed, the best way to restore mobility and strengthen the structures of the foot to reduce and prevent heel pain is through exercise and stretching. In combination with cold rolling and NSAIDs, heel pain treatment exercise and stretches can be a powerful antidote to pain.
It’s important to do these heel pain treatments on both feet, even if heel pain is only present in one.
1. Wall stretches
Face the wall with one foot forward and one foot back (two or three feet between front and back foot). Place hands flat on the wall and lean forward, bending the front knee and stretching the back heel towards the ground.
Hold for 30 seconds, and then switch sides.
2. Big toe flex
Sit on a firm chair and cross one leg over the other. Hold your big toe and pull it towards you.
Hold for 15 seconds and release. Repeat three times, and then move to the other foot.
3. Towel flex
Still seated, wrap a towel around the arch of your foot and hold an end in each hand. Pull the towel toward you as you push the foot away from you.
Hold for 15 seconds, repeat three times, and then switch to the other foot.
4. Marble plucking
Stay in your chair but scatter a handful of marbles or small, smooth pebbles on the ground in front of you. Place an empty mug or bowl near the chair.
One by one, use your toes to grip each marble or pebble to pick it up and drop into the bowl.
5. Wall squat
Stand and face a wall with both feet together. Place hands flat on the wall (you should be close enough so you don’t have to lean forward to do this). Step one foot forward one foot’s length.
Inhale, and on and exhale begin to sink hips back and down into a squat until you feel a stretch in both calves and the back of the heel. Hold for 20 seconds, and then press into both feet to stand up. Switch the forward foot and repeat.
6. Calf and heel stretch
Stand on a step with both feet together and one hand on a railing for balance. Allow your heels to overhang the step. Press into your toes to lift up and release to come down (heels can be level with the step or come slightly below for a bigger challenge).
Repeat ten times, completing two or three sets of ten.
7. Flex and point
Before you get out of bed in the morning, wake your feet up with this simple exercise. Stretch legs out in front of you and sit up tall. Flex and point your feet strongly until you feel a stretch both ways. You can circle ankles, too.
Keep in mind that in the acute phase of heel pain you may not be able to perform some of these exercises. With time and persistence, your flexibility, range of motion, and strength will increase.
Visiting a physical therapist in the acute phase of heel pain can also be vital. They can help you with a specialized exercise plan, ensuring that each exercise targets your particular pain. Physical therapists can also offer tips and suggestions to get the most out of each exercise.
Heel pain relief products
As part of a layered approach to heel pain treatments, you may want to include other support products for pain relief and support.
- Night splints: Night splints are worn while you sleep to keep your Achilles tendon and plantar fascia lengthened
- Orthotics: Custom inserts or shoes can provide more support
- Analgesic creams: Topical analgesic creams can help relieve pain and are available over the counter or by prescription
- Warming (or cooling) creams: These types of creams can provide comfort and pain relief when massaged into feet as directed
The best heel pain treatment approach is a holistic one. Many of these support products can be used in conjunction with exercise, over-the-counter treatments, and medications for heel pain.
Medications for heel pain
Prescription medications for heel pain may include prescription topical analgesic creams. In general, non-steroidal anti-inflammatory drugs (NSAIDs) are the medication of choice for heel pain that has been present for four weeks or less.
If a combination of rest, ice, exercise, NSAIDs, and other supports (e.g. night splints) are not effective for pain relief, your pain specialist may recommend more interventional heel pain treatments.
Interventional heel pain treatments
Interventional pain treatments can be used in conjunction with exercises and other treatments if significant pain is still present. These treatments are minimally-invasive and non-surgical.
There are a variety of injections for heel pain relief, the most common being a corticosteroid injection.
These injections reduce inflammation but may be limited, as too many over time can result in damage to the ligaments of the foot.
TENS unit therapy
Transcutaneous electrical nerve stimulation, more commonly referred to as TENS, is a minimally-invasive way to disrupt the pain signals to the brain. The patient controls the TENS device to send a low-level electrical signal that interrupts the pain signal to the brain.
This does not treat the underlying problem but can offer significant pain relief.
PRP (platelet rich plasma therapy) injects the patient’s own plasma into the affected area to stimulate growth and healing.
Platelets are harvested from the patient’s blood and combined with calcium and thrombin to stimulate the release of growth factors in the platelets that helps to heal damaged ligaments and tissues.
Radiofrequency ablation (RFA) sends a low electrical current through the body, targeting the nerves in the affected area. The electrical current heats up and blocks or destroys the nerve that is reporting pain.
This can offer temporary pain relief and also be used as a diagnostic tool to find out exactly which area is affected. Many patients report not only pain relief but also increased range of motion and mobility after RFA.
The following video gives an overview of this heel pain treatment option.
Do I need surgery for my heel pain?
Because our feet are so crucial to our daily lives, many patients are immediately concerned that their heel pain will require surgery. The good news is that with time, patience, guidance, and persistence, surgery for heel pain is very rare. Only 5% of all plantar fasciitis cases are recommended for surgery when the condition is unresponsive.
The most common type of surgery for heel pain is plantar fasciitis surgery. This involves severing the plantar fascia to relieve pain. Surgery for plantar fasciitis has a high success rate, with most patients reporting no pain and high satisfaction levels with their choice.
Another surgical option is gastrocnemius recession. For patients who continue to have tight calf muscles even after a year of stretches, this surgery uses a small incision to lengthen one of the two calf muscles. Success rates for this surgery are also high.
It is important to note that surgical heel pain treatments may not be considered until a patient undergoes a year’s worth of concerted effort with other treatment options. The reason for this is simple: heel pain of all types responds well to a treatment plan that addresses the painful acute phase while working to heal the underlying cause of the issue. Patients can make significant progress in treatment over time if they are diligent in their efforts, and work with an experienced pain specialist.
If you are experiencing heel pain, get in touch today to discuss heel pain treatments. We believe in the holistic approach to pain treatment and will work hard to come up with a plan that works for you!