Heel pain may also present as Achilles tendonitis. Generally, there are two main areas where heel pain may occur. The first area is the bottom of the heel, which touches the floor taking the brunt of the body weight. The second area of the heel where pain may occur is the back of the heel. This area on the back of the heel is where the achilles tendon attaches to the heel bone. Sometimes this part on the back of the heel will be so painful that tennis shoes and sneakers will rub in this area and worsen the painful symptom.
Another area of pain here at the back of the heel can be from the achilles tendon itself. The tendon may become irritated by micro tears, blunt trauma, overuse, or from external rubbing creating what is known as “achilles tendonitis“. Wearing sneakers may be tolerable, but walking and running can be painful on the back of the leg, just above the heel along the tendon.
It is imperative to seek medical treatment for a thorough examination to determine the cause of the heel pain. Determining the cause will then provide the appropriate course of treatment. Typical, first line, conservative treatments may include rest, ice, immobilization, heel lifts, oral anti-inflammatory medications, and physical therapy. Imaging may involve x-rays and MRIs. Chronic, long-term achilles tendon pain can lead to weakening of the tendon and sometimes spontaneous rupture in the worst cases, therefore it is important to seek a foot and ankle specialist, or podiatrist as soon as possible to determine cause and treatment course. If the tendon is already ruptured, then an MRI is typically ordered to evaluate the integrity of the tendon, the severity of the tear, and to plan a course of treatment.