What causes pain at the back of the heel 2024?

As a medical professional with a focus on orthopedics, I've encountered numerous cases of heel pain and have a deep understanding of the various causes. Pain at the back of the heel is a common complaint that can be attributed to several underlying conditions. Let's delve into some of the most common causes and their explanations.

Plantar fasciitis is often cited as a primary cause of heel pain. This condition involves inflammation of the plantar fascia, a thick, fibrous band of tissue that connects the heel bone to the toes. This fascia acts like a bowstring, providing support to the arch of the foot. When it becomes inflamed, it can cause significant discomfort, especially in the morning or after periods of inactivity. The pain may be deep within the heel or localized to the back of the heel.

Another condition to consider is Achilles tendinitis, which is the inflammation of the Achilles tendon. This tendon connects the calf muscles to the heel bone and is crucial for walking and running. Overuse, poor footwear, or sudden increases in physical activity can lead to micro-tears in the tendon, resulting in pain and sometimes swelling at the back of the heel.

Haglund's deformity, also known as "pump bump," is a bony protrusion on the back of the heel bone. This can cause irritation to the Achilles tendon and surrounding tissues, leading to pain and inflammation. Wearing shoes with a high heel or a narrow back can exacerbate this condition.

Achilles tendonosis is a chronic condition where the Achilles tendon loses its elasticity and becomes thickened and painful. Unlike tendinitis, which involves inflammation, tendonosis is a degenerative process that can be quite painful and is often associated with aging or repetitive strain.

Calcaneal spur is a bony growth that forms on the underside of the heel bone. While they are often asymptomatic, they can cause pain if they press against the plantar fascia or other soft tissues.

Insertional Achilles tendinopathy is a condition where the Achilles tendon becomes inflamed at its attachment point to the heel bone. This can be caused by repetitive stress or degeneration of the tendon fibers.

Soft tissue injuries such as contusions, strains, or tears to the muscles, tendons, or ligaments in the heel area can also result in pain. These injuries can occur due to direct trauma or overuse.

Bone issues like stress fractures or bone tumors can cause heel pain. Stress fractures are small cracks in the bone that can occur from overuse or repetitive impact, while bone tumors, although rare, can press on nerves and cause pain.

Infections and inflammatory conditions like arthritis can also lead to heel pain. Infections can occur from an injury that breaks the skin, allowing bacteria to enter and cause inflammation. Arthritis can affect the joints in the foot, leading to pain and stiffness.

Neurological conditions such as tarsal tunnel syndrome, which is a compression of the posterior tibial nerve, can cause heel and foot pain.

In summary, heel pain can be multifactorial, and it's essential to consider a range of potential causes. Proper diagnosis typically involves a thorough physical examination, patient history, and possibly imaging studies such as X-rays or MRI to identify the underlying issue. Treatment can range from rest, ice, compression, and elevation to more invasive procedures like physical therapy, orthotics, or even surgery, depending on the cause.

Common causes include: Plantar fasciitis, or inflammation of the plantar fascia: The plantar fascia is a strong bowstring-like ligament that runs from the calcaneum (heel bone) to the tip of the foot. ... Pain may be felt deep inside the heel or at the back of the heel. Sometimes, the Achilles tendon may swell.Feb 5, 2018