Heel pain

Heel pain can have various causes. Read all important information about possible causes and treatments here!

Heel pain

heel pain (Medical: Tarsalgia) can have very different causes. For example, in runners pain in the heel is often due to congestion. In addition, for example, bony outgrowths (heel spurs), circulatory disorders, broken bones and rheumatic diseases can trigger heel pain. Read all important information about possible causes and treatments of heel pain here.

Product Overview

heel pain

  • description

  • Causes and possible diseases

  • When do you have to go to the doctor?

  • What does the doctor?

  • You can do that yourself

Heel pain: description

Heel pain is pain in the heel at rest or during exercise. Depending on the location of the heel pain, one differentiates:

  • Lower or plantar heel pain: pain under the heel, often caused by inflammation of the tendon plate (plantar fasciitis) or lower heel spur.
  • Upper or dorsal heel pain: pain at the base of the Achilles tendon, caused for example by an overload or inflammation of the attachment site of the Achilles tendon or an upper heel spur.

Heel pain: causes and possible diseases

The main causes of heel pain are:

Heel pain

Inflammation of the tendon plate of the sole of the foot (plantar fasciitis or plantar fasciitis): Plantar fasciitis is a degenerative disease of the tendon plate on the heel bone (heel bone). The tendon plate connects the heel bump with the ball of the foot, together they form the Fußlängsgewölbe. Heel pain in plantar fasciitis manifests itself as pressure and stress pain.

They occur initially only during exercise, later in the morning and in peace. You can lead to the inability to walk. Typically, heel pain increases the day after exercise. Mostly a sporty running and jumping load is to blame for the heel pain as a result of a plantar fasciitis. In addition, the disease can also occur due to age-related signs of wear in the fourth and fifth decade of life.

Heel Spurs: Pain in the heel may also be due to a calcaneal spur, that is, spine-like bone growth on the heel bone (however, heel spur sometimes causes no discomfort). Depending on the situation, doctors distinguish between the lower (plantar) and upper (posterior) heel spurs.

The lower (plantar) heel spur is also called calcaneal spur and forms on the underside of the heel bump, where the short foot muscles and tendon plate attach to the sole of the foot. It causes severe, circumscribed pressure pain at the mid-lower end of the heel bone, as well as stress-related, stabbing pains on the sole of the foot. In extreme cases, those affected can only occur with the forefoot.

Of the upper (posterior) heel spur also known as Haglund exostosis or Haglund heel; he is less common. This type of heel spur develops at the base of the Achilles tendon. It can cause heel pressure and pain when walking and standing with sturdy shoes. In addition, a circumscribed pressure pain may occur at the Achilles tendon insertion. Incidentally, the heel spur can also occur in connection with a plantar fasciitis.

Pathological changes of the Achilles tendon: Pain in the upper part of the heel is often associated with diseased changes in the Achilles tendon. It is the strongest tendon of the body and connects the calf muscle with the heel bone. Calcification of the Achilles tendon on the heel bone can cause local swelling with pressure pain. An overload or inflammation of the Achilles tendon at its point of attachment to the heel bone may be the cause of heel pain.

Bursitis: In the area of ​​the Achilles tendon insertion and heel bone, there are two bursae that cause heel pain in inflammation. A bursa lies between Achilles tendon and heel bone (Bursa subachillaea). Its inflammation may be due to an upper heel spur, congestion or diseases such as gout. The second bursa (Bursa postachillaea) is located between Achilles tendon and skin; He can, for example, by wearing false footwear (local pressure or friction load!) Ignite.

Fracture: If, for example, a fracture of the heel (such as a fractured heel bone) occurs as a result of an accident, he may also experience heel pain. In addition, a so-called fatigue fracture (stress fracture) can occur on an increasingly stressed bone, such as in runners. They suffer fatigue fractures, especially in the area of ​​the tibia, metatarsus and heel. In the latter case, heel pain.

Ankylosing spondylitis (ankylosing spondylitis): Ankylosing spondylitis is a chronic inflammatory, rheumatic disease that can lead to bony stiffening of the wedge and often affects other joints as well as organs of the body. Common symptoms include, for example, joint inflammation, morning stiffness of joints, side-changing buttocks pain with reduced mobility of the lumbar spine and radiating pain in the thighs, and heel pain.

S1 syndrome: Heel pain can also have its origin in a pinched nerve in the area of ​​the spine, more specifically in a so-called S1 syndrome: Here, a nerve root is constricted, which emerges from the spinal cord at the first sacral vertebra. The narrowing can occur, for example, due to a herniated disc at this point. The result is one-sided pains that run from the buttocks over the back of the thigh and lower leg. They radiate into the heel to the outer edge of the foot (including toes three to five).

tarsal tunnel: Here, too, a nerve is trapped, namely the tibial nerve in its course through the tarsal canal. This is a kind of tunnel formed by anklebone, heel bone and inner ankle and a band-like structure as the "roof" of the tunnel. The symptoms of tarsal tunnel syndrome include ants running, burning and discomfort on the entire sole of the foot, in the area of ​​the flexor tendons toe or only on the heel. The heel pain can radiate to the calf. In addition, a pronounced pressure pain behind the inner ankle and a reduced sweat secretion on the sole of the foot occur.

Fusion of heel and scaphoid bone (Coalitio calcaneonaviculare): The congenital fusion of heel and navicular bone is associated with limited mobility in the lower ankle joint and in the chopart joint (tarsal joint). After initial pain relief, the first symptoms usually become noticeable at school age: Longer standing and walking triggers chronic foot pain (including heel pain). In addition, a feeling of stiffness occurs during foot movements.

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Heel Pain: When do you need to see a doctor?

Go to the doctor:

  • Longer lasting heel pain.
  • Heel pain that increases under exercise.
  • Heel pain, which restricts the walking movements.
  • Heel pain accompanied by further discomfort, for example joint swelling.

Diseases with this symptom

  • achillodynia
  • Dupuytren's contracture
  • Heel Spurs
  • fibroma
  • mouse arm
  • Sudeck's disease
  • plantar fasciitis
  • Housemaid's knee
  • tarsal tunnel syndrome

Heel Pain: What Does the Doctor Do?

Heel pain: diagnosis

At the beginning of the doctor's visit is the collection of medical history (medical history). That said, the doctor will interview you in detail about your heel pain. It is important, for example, how long the heel pain already exists, exactly where they occur and whether other complaints are present, for example pain in the back of the leg. Various examinations can help in finding the exact cause of heel pain. The most important are:

  • Physical examination: For example, the doctor tests whether pressure pain or bony swelling in the heel area (heel spur) is present. He also checks, for example, the joint mobility, muscle strength and gait.
  • X-ray examination: For example, bone fractures, a heel spur, and a fusion of heel and navicular bone can be identified on x-rays as a trigger for heel pain. In addition, X-ray examinations are performed if Bechterew's disease could be behind the heel pain.
  • Magnetic Resonance Imaging (MRI): If the cause of heel pain, for example, pathological changes in the Achilles tendon in question, you can perform a closer examination, a magnetic resonance imaging. Magnetic resonance imaging also helps with suspected ankylosing spondylitis as the cause of heel pain.
  • Electromyography (EMG) and Electronurgical (ENG): The electrical activity of muscles and nerves is examined, if, for example, a tarsal tunnel syndrome could be responsible for the heel pain.

Heel pain: treatment

If an underlying condition (such as heel spur) or injury (such as bone fracture) causes the heel pain, it must be treated. In a heel spur, for example, special insoles for the shoes, physical therapies (such as circulation-promoting foot baths and shock wave therapy) as well as analgesic medications are recommended. A heel spur is usually only operated when the conservative therapies remain unsuccessful.

Heel Pain: You can do that yourself

  • Being overweight puts excessive weight on the feet. This promotes heel spurs and other foot problems. Try to lose weight if you put too many pounds on the scale.
  • Deformations of the feet (such as the foot) can lead to heel spurs and thus trigger heel pain.Therefore, let you handle deformities.
  • Try to avoid standing for hours.
  • Avoid too tight shoes.
  • Warm up your muscles, tendons, and ligaments before exercising. Otherwise, for example, it can easily lead to overuse and inflammation in the area of ​​the Achilles tendon with possible heel pain.
  • Do not overdo it with the training. This will help prevent fatigue fractures with subsequent heel pain or other discomfort.
  • High-altitude positioning of the foot, cooling and protection can be the first measures to relieve acutely occurring heel pain. An example is overstressing the Achilles tendon or inflammation of the tendon plate.
  • Always take pain in the heel seriously and refrain from exercising or stop exercising when heel pain occur.


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