Heel pain is becoming increasingly common in Singapore, affecting people from all walks of life. While it often develops gradually, it is influenced by a combination of medical conditions and everyday habits. Conditions like Plantar Fasciitis, heel spurs, and Achilles Tendonitis frequently cause discomfort, but lifestyle factors play an equally important role. Long hours spent standing or walking on hard surfaces, whether at work or during commutes, create additional strain on the heel, often exacerbating the discomfort caused by these conditions. This strain can be worsened by unsupportive shoes or the habit of walking barefoot at home, both of which intensify the pain. Many people also overlook the importance of proper footwear, missing an opportunity to prevent or manage heel pain. By understanding the causes of your heel pain, you can take the first step toward finding relief and regaining comfortable movement.
Types of Heel Pain
Heel pain can stem from various conditions, each requiring specific attention and care. Here are the most common types:
- Achilles Tendonitis: Inflammation of the Achilles tendon, connecting the calf muscle to the heel bone, often caused by overuse. This results in pain and stiffness at the back of the heel, especially during activity.
- Haglund’s Deformity: A bony bump on the back of the heel caused by irritation, commonly from wearing stiff or high-backed shoes. It results in swelling and discomfort at the back of the heel, often referred to as “pump bump”.
- Heel Bursitis: Inflammation of fluid-filled sacs (bursae) around the heel. There are three types:
- Retrocalcaneal Bursitis: Inflammation between the Achilles tendon and heel bone, typically from repetitive movement or tight footwear.
- Subcutaneous Calcaneal Bursitis: Swelling between the skin and Achilles tendon, usually from direct pressure from shoes.
- Sub Achilles Bursitis: Occurs beneath the Achilles tendon, causing tenderness at the back of the heel, often linked to overuse or pressure.
- Heel Spurs: Bony growths on the bottom of the heel bone, usually associated with Plantar Fasciitis. They can cause sharp pain, especially when standing after rest, but aren’t always symptomatic.
- Plantar Fasciitis: Involves inflammation of the plantar fascia, a thick band of tissue that supports the arch of the foot. Pain is usually felt under the heel, especially with the first steps in the morning or after long periods of inactivity.
- Sever’s Disease: This is a paediatric condition that affects children during growth spurts. It is caused by irritation of the growth plate in the heel, leading to pain that is typically triggered by high-impact movements.
- Stress Fractures: Small cracks in the heel bone (calcaneus) due to repetitive force or overuse. Stress fractures lead to consistent pain, especially during weight-bearing activities, and are common in athletes.
- Tarsal Tunnel Syndrome: Occurs when the posterior tibial nerve becomes compressed. This results in pain, tingling, or numbness in the heel and can extend to the rest of the foot.
Common Causes of Heel Pain
Heel pain can arise from a wide range of factors, from common lifestyle habits to underlying medical conditions. Here are some potential causes:
- Overuse and Repetitive Stress: High-impact activities like running, jumping, or prolonged standing can overstress the heel, leading to conditions such as Plantar Fasciitis or stress fractures, which develop over time due to repeated strain.
- Improper Footwear: Wearing shoes without adequate support or cushioning can misalign the foot, increasing pressure on the heel. This often leads to conditions like Plantar Fasciitis or heel spurs, which develop from ongoing strain.
- Abnormal Walking Style: A gait issue like overpronation, where the feet roll inward, can place undue stress on the heel. This imbalance contributes to the onset of conditions like Achilles Tendonitis or Plantar Fasciitis.
- Weight Gain or Obesity: Extra weight puts significant pressure on the heel, aggravating existing conditions such as Plantar Fasciitis. The added strain also increases the likelihood of injuries like stress fractures in the heel bone.
- Standing or Moving on Hard Surfaces: Prolonged periods of standing or walking on hard surfaces cause stress on the heel’s tissues, leading to inflammation. This impact increases the risk of developing conditions like Plantar Fasciitis or Bursitis.
- Age-related Changes: As we age, the fat pad under the heel naturally thins, reducing cushioning and increasing the risk of developing conditions like Plantar Fasciitis or heel spurs due to reduced protection for the heel.
- Heel Trauma: Direct impact or continuous micro-trauma to the heel can cause conditions like stress fractures or inflammation of the bursae. These injuries often result from physical activities that repeatedly stress the heel.
- Bursitis: Repetitive pressure or irritation can inflame the bursa, small fluid-filled sacs that cushion joints. This inflammation, particularly Retrocalcaneal Bursitis, can cause significant heel pain during movement.
- Growth Spurts in Children: A common cause of heel pain in active children. It involves inflammation of the growth plate during growth spurts. It’s often triggered by repetitive activities like running or jumping.
- Underlying Medical Conditions: Systemic autoimmune diseases like Rheumatoid Arthritis and diabetes can contribute to heel pain. Arthritis causes joint inflammation, while diabetes can lead to nerve damage and poor circulation.
Symptoms of Heel Pain
Heel pain can stem from various conditions, each presenting distinct symptoms. Here’s a list of common symptoms:
- Sharp Pain: Common in Plantar Fasciitis, this pain is worst in the morning after rest, as the plantar fascia tightens during inactivity. While movement can ease the pain, prolonged standing or activity often brings it back.
- Swelling and Tenderness: Frequently seen in Achilles Tendonitis or heel Bursitis, this includes swelling around the back or bottom of the heel, often worsening with walking or pressure. The heel may feel warm to the touch.
- Stiffness and Limited Mobility: Seen in Achilles Tendonitis and heel Bursitis, this includes stiffness, especially after inactivity, which makes it difficult to flex or extend the foot fully.
- Morning Stiffness and Joint Pain: Conditions like Rheumatoid Arthritis can cause heel pain along with morning stiffness. This is often accompanied by swelling and discomfort in other joints as part of a broader inflammatory response.
- Dull, Aching Pain: Associated with heel spurs or chronic Plantar Fasciitis, this persistent pain worsens with extended standing or walking and may spread toward the arch of the foot.
- Bruising and Localised Pain: Seen in stress fractures, this includes bruising and localised pain that intensifies with weight-bearing activities like walking or running. The pain typically worsens over time.
- Radiating Pain: Conditions such as Plantar Fasciitis or Tarsal Tunnel syndrome may cause pain to spread from the heel to the arch or toes, particularly during walking or standing.
- Burning or Tingling Sensation: Often linked to Tarsal Tunnel syndrome, this includes a burning or tingling sensation that radiates from the heel to the toes, usually due to nerve compression.
- Redness, Heat, and Sudden Pain: While gout usually affects the big toe, it can sometimes cause sudden heel pain with redness and swelling due to uric acid buildup in the joint.
- Pain Triggered by Activity: In Sever’s Disease, common in children, heel pain worsens during physical activity such as running or jumping and improves with rest. Pain is usually localised at the back or bottom of the heel.
- Numbness or Cold Sensation: Poor circulation, as seen in Peripheral Arterial Disease (PAD) or diabetes, can lead to numbness or a cold sensation in the heel, accompanied by chronic pain that worsens with activity.
- Menopausal Joint Pain: The drop in oestrogen during menopause can lead to joint stiffness and heel pain. Hormonal changes also often cause weight gain, adding extra stress on the heel and worsening discomfort.
Heel Pain Management and Prevention
In Singapore, heel pain is addressed through a range of care options, which vary depending on the cause and severity of the condition. Whether the pain is mild or severe, conservative methods are often the first step, while more advanced options are available if needed. Common care methods include:
- Rest and Ice: Resting the heel and applying ice helps reduce inflammation and alleviate pain, particularly for overuse injuries.
- Stretch and Strengthen: Stretching the calf muscles and plantar fascia, along with strengthening exercises, helps improve flexibility and provides better support.
- Anti-inflammatory Medication: Nonsteroidal Anti-inflammatory Drugs (NSAIDs) help reduce swelling and provide pain relief.
- Sports Taping: Taping the foot provides temporary stability, reducing strain on the heel and offering relief during physical activities.
- Custom Shoe Insoles: Customised orthotics offer support to the heel and arch, distributing pressure more evenly and reducing stress on the heel.
- Extracorporeal Shockwave Therapy (ESWT): ESWT is a technology that promotes healing and regeneration by stimulating the affected tissue with acoustic waves.
- Extracorporeal Magnetotransduction Therapy (EMTT): EMTT is a technology that uses electromagnetic pulses to accelerate tissue repair and reduce heel pain.
For those who have experienced recurring heel pain, here are some preventive measures to consider:
- Shoes that Fit Properly: Make sure your shoes offer support and cushioning. Avoid shoes with worn-down heels or soles, as they can contribute to heel pain.
- Avoid Walking Barefoot on Hard Surfaces: Walking barefoot on hard surfaces puts unnecessary strain on the heel, leading to discomfort.
- Use Heel Pads or Inserts: Heel pads or custom orthotics can absorb shock and reduce pressure on the heel, especially during prolonged standing or walking.
- Maintain a Healthy Weight: Keeping a healthy weight reduces stress on the heels, lowering the risk of pain or injury.
- Warm Up Before Any Activity: Proper warm-up exercises before engaging in physical activity can help prevent heel pain by preparing the muscles and joints.
- Rest Your Feet: Take breaks from standing whenever possible to reduce strain on the heel and prevent overuse.
Get Relief from Heel Pain at East Coast Podiatry
At East Coast Podiatry, we understand how debilitating and frustrating heel pain can be. As Singapore’s leading podiatry clinic, we provide personalised care plans tailored to your specific needs, ensuring you receive the best care for your condition.
Whether your heel pain stems from Plantar Fasciitis, gout, menopausal joint pain, or other related conditions, our team utilises the latest techniques and technology to address a variety of heel problems. From customised foot orthotics to advanced non-invasive methods such as Extracorporeal Shockwave Therapy and Extracorporeal Magnetotransduction Therapy, we offer comprehensive options designed to relieve pain, promote healing, and restore mobility. We also emphasise preventive care to help you avoid recurring issues.
Don’t let heel pain disrupt your daily routine. Contact us today to schedule a consultation and begin your path to recovery. Our dedicated team is here to provide the support you need to regain healthy, pain-free feet.
Frequently Asked Questions About Heel Pain
Heel pain typically develops when the calcaneus, the largest bone in the foot, is subjected to excessive stress or inflammation in the surrounding tissues. This bone plays a crucial role in absorbing the impact of walking, running, and other weight-bearing activities. Conditions like Plantar Fasciitis (inflammation of the connective tissue beneath the foot) and Achilles Tendonitis (inflammation of the Achilles tendon) commonly lead to heel pain. When left alone, heel pain can affect mobility and posture, making each step painful and limiting daily activities.
Heel pain is most often caused by repetitive stress or overuse, leading to conditions like Plantar Fasciitis, where the thick band of tissue supporting the arch becomes inflamed, or heel spurs, which are bony growths on the heel bone. These conditions are commonly aggravated by activities such as prolonged standing, walking, or running on hard surfaces. Inflammatory conditions like Rheumatoid Arthritis or gout can also lead to heel pain due to joint inflammation, further contributing to discomfort and stiffness in the heel. Addressing the underlying cause is key to the management of this condition.
If you’re experiencing sharp, stabbing pain in the bottom or back of your heel, especially when taking your first steps in the morning or after periods of rest, it could indicate heel pain. Other common signs include tenderness, swelling, and aching in the heel, particularly after walking or standing for long periods. You may also feel pain during or after physical activities such as running. If you notice discomfort when wearing certain shoes or experience stiffness in the heel after rest, these are additional indicators of heel pain. If symptoms persist, it’s advisable to see a podiatrist for proper diagnosis.
NSAIDs can help reduce inflammation and provide temporary relief from heel pain, but they are unlikely to fully resolve the issue if used alone. Heel pain is often caused by conditions such as tissue strain, overuse, or other structural problems in the foot. While NSAIDs may ease symptoms, they do not address the root cause of the pain. To achieve lasting relief, NSAIDs should be combined with other methods like rest, stretching exercises, or supportive footwear. Consulting a podiatrist for a proper diagnosis is essential to effectively manage and resolve heel pain.
At East Coast Podiatry, we offer a range of options for heel pain, tailored to each patient’s specific needs. Our podiatrists use a combination of methods to promote healing, manage pain, and prevent recurrence. Below are some service offerings we provide:
- Custom Foot Orthotics: Specially designed shoe inserts that provide support to the heel and arch, helping to redistribute pressure and relieve pain in the heel.
- Extracorporeal Shockwave Therapy: A non-invasive technology that uses acoustic waves to stimulate healing and reduce chronic heel pain.
- Extracorporeal Magnetotransduction Therapy: An advanced technology that uses electromagnetic pulses to accelerate tissue repair and reduce inflammation.
- Physiotherapy and Exercises: Targeted stretches and strengthening exercises help improve flexibility and foot support, reducing heel pain and preventing future injury.
- Sports Taping: Application of sports tape to the foot to provide additional support and cushioning to reduce strain on the heel and offer pain relief.
