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Dealing with Heel Pain

Heel pain, (also known as hielpijn in Dutch), a condition that may sound quite odd at first but is actually surprisingly common, occurs in about 10% of the population. The pain caused by the condition can vary from mild to severe and often worsens over time if left untreated. Let’s look at some of the facts so we can learn more about this condition.

What Causes Heel Pain?

Heel pain is usually caused by the damage and/or thickening of a band of tissue, known as the plantar fascia that is situated in the foot. Damage in the form of microtears or tiny tears can occur over a number of years or from sudden strain to the tissue. These microtears cause the tissue to swell and put strain on the heel bone, resulting in the pain. Usually, damage that occurs over a few years affects adults over the age of 40 whereas sudden damage is often seen in young, physically active people who are runners or joggers. There are also a number of factors that can increase the chances of heel pain in both young and old people. These are having a high BMI (body mass index) which is associated with being overweight or obese, working in an environment that requires long periods of standing and even if you constantly wear shoes with flat soles such as slip slops.

Symptoms of Heel Pain

The most commonly experienced symptoms of heel pain are quite straightforward- most people experience pain in only one heel (although pain in both heels does occur). morning heel pain is usually experienced by most sufferers of the condition when you put pressure on your heel after a long period of rest. Pain can also be experienced after shorter periods of inactivity and whilst it lessens with walking, can often worsen again after long periods of standing.

Diagnosis of Heel Pain

By visiting your General Practitioner (GP) or a specialist if necessary, he or she will be able to confirm a diagnosis of heel pain. Your doctor will want to know about any other symptoms that may indicate a different condition such as arthritis (if you have swelling in your foot) or a bone infection (if the temperature in your foot is abnormally high). Blood tests, X-Rays and MRI or ultrasound scans may also be used to determine the correct diagnosis of the condition.

Treatment of Heel Pain

There are many ways to treat hell pain. The treatment of heel pain is relatively simple although it requires commitment to the treatment plan which will often involve a combination of approaches. Pain killers such as non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed although it is not advised to use them for an extended period of time so these would only be used intermittently and in more serious cases. In most instances, your doctor will provide you with useful foot exercises that will focus on strengthening and stretching your calf muscles and plantar fascia (the tissue that is resulting in the pain). It is advisable to exercise both legs even if you are only experiencing pain in one heel- this acts as a prevention strategy for the non-affected foot.

Another alternative to alleviate the heel pain is to wear shoes that cushion the heel and support the arch of the foot. Shoes that are completely flat are usually not suitable and can exacerbate the pain. The option also exists to use insoles that fit into your shoe that will support your foot while the damaged tissue is given time to heal.

In extreme cases that do not respond to the abovementioned treatment methods, corticosteroid injections may be recommended. These injections have a strong anti-inflammatory effect but need to be used with caution as they may cause high blood pressure and weight gain. As a last resort, surgery may be done where the plantar fascia is actually cut to release the tension on the heel bone. This is usually only done for professional athletes where the pain has become career limiting.


Heel pain should not be left untreated as it can get worse over time and then require more extreme treatment measures. If you feel that you may be at risk for heel pain (refer to common risk factors mentioned above), it is advisable to do regular stretching exercises and to invest in appropriate footwear. If you do suffer from heel pain, with the correct exercises, footwear and medication, it is a condition that can be easily treated and you will be pain free again.

Following the above tips will help you whether you are a professional athlete or just suffering from heel pain.


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