Heel pain/Achilles tendonitis
What is it?
Otherwise known as policeman’s heel, this pronounced discomfort around the heel of the foot is very common, and can be quite debilitating.
Why does it occur?
Heel pain is not in itself a diagnosis and can be caused by a number of different underlying conditions, and identifying the precise location of the pain will give your consultant some idea of the possible cause. Plantar fasciitis, which is the inflammation of the thick lining of the sole beneath the heel, is the most common cause. Others include: Achilles tendonitis, which is inflammation of the Achilles tendon at the point it attaches to the heel bone; stress fractures of the calcaneus (heel bone); or osteoarthritis.
What are the symptoms?
This is most commonly experienced as a dull, aching pain around the heel, particularly while walking. Moving your foot backwards and forwards is painful and can be worst when standing after a period of inactivity, such as getting out of bed in the morning. Walking long distances can also trigger symptoms.
How is it diagnosed?
Careful examination, often with the aid of x-rays and ultrasound scans, will help your consultant to accurately diagnose the underlaying cause of any heel pain.
How is it treated?
In the vast majority of cases, heel pain can be treated without the need for surgery. Very often rest, ice, compression and anti-inflammatories can ease the symptoms. Physiotherapy to stretch out the muscles and tendons around the ankle, and adapting your footwear with insoles and heel pads, will often dramatically reduce the pain.
Shockwave therapy or injections into the heel area to treat the underlying inflammation may be required. Whether more invasive treatment is required will depend on the precise cause of the pain, but releasing the muscle behind the calf to reduce the tension where the Achilles tendon (at the back of the heel) goes into the plantar fascia (at the bottom of the heel) is sometimes required.
Achilles tendon reconstruction
The One Orthopaedics team specialists
Consultant Orthopaedic Foot and Ankle Surgeon FRCS (Tr & Orth)