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Heel Pain: Treatment, Procedure, Cost and Side Effects

Last Updated: Oct 07, 2021

What is the treatment?

Heel pain is the most common problem of the foot. One who suffers from it usually feels the pain under the heel which is called Plantar Fasciitis or behind it known as the Achilles Tendinitis. The latter is the area in which the Achilles tendon connects to the heel bone. Even though severe heel pain can be considered disabling, it is only rarely a threat to the health. Heel pain is generally mild and sometimes disappears on its own. On the other hand, there are some cases in which the pain persists for a longer period and also eventually becomes chronic (long-term).

A podiatrist is a doctor who is specialized in the examination and treatment of diseases associated to the foot. Firstly, he will start from a proper physical inspection and will keep asking a few pertinent questions from the patient related to his condition. He will then ask him about him/her about his medical history, the type of footwear he wears on a daily basis and many more questions to fully know about his situation. The diagnosis is then followed by an imaging scan and blood tests. The treatment methods comprise of non-steroidal anti-inflammatory drugs, corticosteroids, orthotics, extracorporeal shock wave therapy, physiotherapy and night splints. In case of severe heel pain the doctor may recommend a surgery.

What are the symptoms of heel bursitis?

Bursitis refers to an inflammation in the bursa of the heel bone. The symptoms mainly include pain in the bursitis region of the heel while walking or running and by touching the affected area.

Redness and warmth in the skin of the back area of the heel are also unignorable. The Pain worsens when the affected person tries to stand on his tiptoes.

How long does Heel Pain last?

Heel Pain, referred to as Plantar fasciitis is the condition in which people of all age groups are affected. Gout may be one of the causes. In chronic conditions, consultation with doctors is necessary for the diagnosis. In most cases, it gets away on its own without undergoing any treatment.

It can take up a long time to be resolved depending upon the severity of the pain, but specific exercises such as foot exercises and calf stretches can decrease the recovery time significantly.

Is Heel Pain due to uric acid?

Heel Pain may be due to the presence of abnormal levels of uric acid in a person’s body, a condition commonly known as gout. In such cases, consultation with the doctor is necessary. Blood tests are recommended in such conditions for a proper diagnosis. The report showing the normal level of uric acid in the blood does not necessarily mean that the person is not having gout.

How is the treatment done?

The vast majority of individuals tend to recover with conservative treatment methods which are designed to avoid any kind of operative or radical medical therapeutic measures of treatment. Owing to the reason that plantar faciitis is associated with inflammation, the doctor recommends non-steroidal anti-inflammatory drugs which are commonly referred to as NSAIDs to treat this condition. An anti-inflammatory drug called ibuprofen needs to be taken at 600-800 mg/day for three times as per the prescription. This treatment has to go on for about 10 days to 2 weeks for relieving the pain. This medication only acts like a pain reliever and not a healer as it only reduces the inflammation of the affected area.

Orthotics (assisted devices) or insoles are useful for cradling and cushioning the arch amid the healing process. It is also known to correct foot faults. In order to encourage and stimulate the healing process there are shock waves that are passed through the affected area. Only in cases of long-term stubborn and chronic heel pain is this therapy recommended by doctors. Surgical treatment involves the removal of plantar fascia from the heel bone. This procedure is the last alternative if all other methods fail. It is a big risk to go for this treatment as the arch of the foot will subsequently weaken over time.

When should I be concerned about Heel Pain?

Heel Pain becomes the matter of concern in the following conditions:

  • Occurrence of pain and swelling in the affected area.
  • Not being able to walk properly.
  • When a person is unable to bend his toes downward.
  • When the pain in the heel is accompanied by fever, numbness, or tingling in that particular region.
  • When an injury in the heel is followed by severe pain.
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Who is eligible for the treatment? (When is the treatment done?)

Pain is itself a symptom that occurs mainly due to injury of bodily tissues. However, some of the signs that are associated with pain might give an idea whether he/she is eligible for treatment These include depression, flu-like symptoms, loss of appetite, numbness, muscle spasms, inability to concentrate, sleep disturbances and unexpected weight loss. When a person experiences heel pain together with some other symptoms, it may be indicative of a life-threatening ailment. Pregnant women are eligible for the medications as instructed by the doctor for specific doses. A person should consult a doctor before undergoing any treatment. The doctor will take the final call on whether a person is eligible for treatment or not.

Who is not eligible for the treatment?

Pain can be experienced due to a variety of causes. A person can wrongly diagnose any pain arising out of any serious complication to be a random heel pain. Some serious diseases which are commonly undiagnosed can be nerve diseases like diabetic neuropathy, peripheral neuropathy and chronic disorders like fibromyalgia, arthritis, migraine and chronic pain syndromes. Thus it is of paramount significance to visit a doctor and get the proper diagnosis. People suffering from severe diseases or underlying conditions and experiencing pain due to that are not eligible for the treatment.

Are there any side effects?

Some of the side-effects of heel pain relief are: fatigue, soreness, muscle twitching, lightheadedness, emotional distress and bruising. Some medications relieve pain and their side effects include indigestion and other gut problems, headaches, dizziness and drowsiness. Prolonged usage of medications can affect kidneys, liver, heart and blood circulation and can also cause fluid retention. Furthermore, some of the side-effects of analgesics are constipation, drowsiness, skin rashes, dry mouth, upset stomach and ringing in the ears.

What are the post-treatment guidelines?

The recovery period of a patient who has undergone heel surgery depends on several factors including the condition of the patient before the surgery, the experience and skill of a surgeon and the extensiveness of the surgery. Using analgesics to relieve pain for a long period of time can lead you to addiction. When a person is on analgesics, he/she should avoid performing tasks that require a lot of awareness like driving a car. When a person is on analgesics, he/she should not consume alcohol. An acupuncture session makes you feel relaxed and so a person should not go for any intense workout session afterwards. There are some changes in body energy and a doctor normally advises people to bring some changes in their diet. Physical therapies are typically prescribed to encourage healing and rebuilt the range of motion, flexibility and strength.

How long does it take to recover?

It takes approximately 2-3 weeks to recover from this condition. You also need to take various measures of prevention. In case of acute or chronic pain the timing may be longer. It all narrows down to the lifestyle measures adoption and maintained.

What is the price of the treatment in India?

The cost of surgical treatment for heel pain is Rs. 2,25,000 to Rs. 4,20,000. The cost of medication ranges from Rs. 315 to Rs. 500.

Are the results of the treatment permanent?

No medication is known to heal or cure the pain permanently. There are different aspects that need to be covered in order to gain a permanent treatment. Heel pain is most likely to reoccur if the lifestyle of a patient remains the same. Dietary measures along with regular exercise are needed in order to avoid the problem.

What are the alternatives to the treatment?

There are several alternative treatment methods for healing heel pain. These include heat therapy (application of a warm cloth on the affected area to provide relief), acupuncture (inserting a needle gently on the affected area to release pain), and massage therapy (pressure applied to the affected area for pain reduction).

Is walking good for Heel Pain?

Depending on the severity of the pain in the heel, there are two conditions that arise as a result of walking in that condition. In case the pain becomes severe due to walking, one should avoid it till the pain subsides. Walking barefooted should be avoided and some supportive measures should be preferred such as shoes with an orthopedic cushion or heel seat wraps.

In case walking is not accompanied by any pain, one should prefer brisk walking. Doing light exercises and warm-up prior to the walk should be done.

What exercises are good for Heel Pain?

Exercise is the key to good health. In the case of Heel Pain, exercises are proved to be beneficial for the treatment of such conditions. Strengthening as well as exercises plays an important role in pain reduction and they also improve walking.

Some of them that are preferred in case of Heel Pain include Plantar fascia massage, heel raise, floor sitting ankle inversion with resistance, seated toe towel scrunches, seated plantar fascia stretch, and wall facing calf stretch.

Summary: Heel Pain, referred to as Plantar fasciitis is the condition in which people of all age groups are affected. It may be due to the presence of abnormal levels of uric acid in a person’s body, a condition commonly known as gout. It can get resolved spontaneously in most of the cases which are mild, while chronic cases need to be consulted with doctors. It can take up a long time to be resolved depending upon the severity of the pain, but specific exercises such as foot exercises and calf stretches can decrease the recovery time significantly.

References

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Written ByDr. Sidharth Verma PDCC - Pain Management,MD - Anaesthesiology,DNB Anaesthesiology,MBBSOrthopaedics
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