The most common causes of heel pain are plantar fasciitis and bruised heel. Plantar fasciitis is very common and involves inflammation of the plantar fascia or arch of the foot. If you have pain on the top of the foot, then extensor tendinitis or metatarsal fracture are both common. Ball of foot pain can be sesamoiditis (pain at the base of the big toe) or metatarsalgia which is a general term for pain around the joints in the forefoot.
Common Symptoms:
- Pain developed gradually
- Pain increases with exercise
- Pain at the back of the heel
- Tender to touch the heel bone
- Swelling
- Red and warm to the touch
- Footwear rubs and aggravates the pain
- Pain eases with rest
- Pain after exercise
- Sudden onset of pain
- Bruising
- Tingling or numbness
- Deformity
- Pain on the outer midfoot
- Pain on the outer ankle
- Tender to touch on the outer midfoot
- Pain when running a curve
- Reduced ankle movement
- Pain on weight bearing
- Tender to touch on the outer ankle
- Tenderness when pressing the Achilles tendon
- Nodules or lumps felt in the Achilles tendon
- Pain worse in the morning
- Pain at the back of the ankle
- Stiffness in the mornings
- Clicking, catching, or locking
- Pain when the ankle is forced into plantar flexion (downward)
- Pain inside the ankle joint
- Inability to weight bear
- Pain in the shin
- Pain the morning after exercise
- Tender to press just inside the shin bone
- Pain on stretching the shin muscles
- Pain when starting exercise which fades throughout
- Pain when pressing a specific point on the bone
- Pain on the outer leg
- Weakness when lifting the foot upward
- Constant pain
- Pain at the front of the ankle
- Pain when lifting the foot up against resistance
- No pain
- Foot drop
- Pain in the Achilles tendon
- A popping/snapping sound or sensation
- A gap may be felt in the Achilles tendon
- Inability to stand on tip toes
- No foot movement when squeezing the calf muscles (Thompson’s test)
- Pain when rising onto tip toes
- Pain in the calf
- Tight calf muscles
- Tender to press into the calf muscles
- Pain when stretching the calf muscles
- Decreased sensitivity in the front/side of the leg or top of the foot
- Spasm of the muscles
- Pain in the back of the knee
- Pain when pressing the inner top of the calf muscles
- A hard area in the calf muscles
- Pain on the inner ankle
- Pain when pointing the foot down
- Pain on kicking a ball
- Tender when pressing in the front of the ankle
- A bony lump at the front of the ankle
- Pain when pushing the foot outward against resistance
- Pain when turning the sole of the foot in against resistance
- Tender to touch the inner ankle
- History of tibialis posterior injuries
- A fallen arch
- Pain when the ankle is forced into dorsiflexion (upward)
- Tender to touch the ankle bone
Plantar Faciitis
The plantar fascia, band of tissue under the foot, becomes inflamed causing heel pain which may radiate into the foot. Pain is worse the first thing in the morning but eases off, only to gradually get worse later on.
Heel Spur
Heel pain similar to plantar fasciitis. A heel spur is a growth underneath and inside the heel where the plantar fascia attaches. Symptoms are similar to plantar fasciitis but a heel spur can be present without pain and vice versa.
Bruised Heel
Pain under the heel bone often caused by overuse. A bruising of the fat pad under the heel occurs. This is common with soldiers marching or overuse through running and jumping. Another name for this condition is Policeman’s Heel.
Achilles Bursitis
Pain and inflammation of the bursa which sits between the Achilles tendon and the heel bone. Symptoms include pain at the back of the heel where the Achilles tendon attaches to the bone.
Sever’s Disease
A common cause of heel pain effecting young athletes. Pain is felt at the attachment of the Achilles tendon to the heel bone. It is due to the bone crumbling. The young athlete should grow out of it as long as the injury is treated properly.
Achilles Tendinopathy
Pain, inflammation, and thickening of the Achilles tendon at the back of the ankle. This is a common overuse injury which may become chronic causing degeneration of the tendon (tendinosis).
Broken Toe
A fracture of any of the phalange bones of the toes. Symptoms are usually obvious pain from an impact or trauma. If the injury is a stress fracture, then the toe pain will be more gradual onset through overuse.
Navicular Stress Fracture
A poorly localized midfoot pain or ache associated with exercise. A stress fracture will come on gradually due to overuse and may not be visible on X-ray until after the injury has started to heal.
Morton’s Neuroma
Foot pain in the forefoot, specifically between the third and forth toes where the nerve passes. Pain is made worse by squeezing the forefoot and compressing the nerve.
Metatarsalgia
Inflammation of the MTP joints in the forefoot causing toe pain when walking. Metatarsalgia is also an umberella term used to describe pain in the forefoot which may have a number of causes.
Hallus Rigidus
Pain and stiffness in the first MTP joint at the base of the big toe. Symptoms include toe pain at the base of the big toe or great toe with swelling and inflammation.
Ingrown Toenail
Ingrown toenails are common problems causing pain, redness, and sometimes infection. They may be caused by not cutting the nail correctly or poor choice of footwear.
Black Toenail
A black toenail or subungual hematoma is a common problem resulting from direct trauma or impact to the toe. It can also be caused by repetitive trauma from a shoe rubbing on the toe in the case of long distance running or walking.
Metatarsal Fracture
A break in one of the five metatarsals or long bones between the ankle and toes, often caused by impact to the foot from another shoe or boot. The athlete will experience midfoot pain at the point of injury and be unable to put weight on the injury.
Extensor Tendonitis
An overuse foot injury with pain on the top of the foot, made worse by lifting the foot and toes upward. This foot pain may be caused by over tightening shoe laces.
Getting a Diagnosis for your foot and heel pain
If you have tingling, numbness, or pain in your foot or heel, see a doctor. He or she will take your medical history, examine you, and possibly perform tests. These may include X-rays, imaging scans, or blood tests. After the examination, the pain management doctors and pain management professionals at Modern Pain Solutions will clearly explain to you the condition, possible sources of your pain, and which pain treatment will help alleviate your pain along with possible course of action and next steps.
Our providers will help determine the best course of action to help you with your foot and heel pain.