Pain in the back of the heel

    Auteur: Podiatre Montreal

    It is therefore essential if you suffer from acute pain under the heel to consult a specialized health professional such as a Podiatrist who will be able to establish a diagnosis based on various tests such as biomechanical and radiographic examinations and propose an appropriate treatment to remedy the detected affection. Depending on the condition and the existing symptoms (inflammation of the tissue, state of the tendons, state of the heel bones, presence of bruises, etc.), the treatments may be different and may range from rest to surgery, from custom-made insoles to re-education.

    The causes of pain in the back of the heel

    The causes of heel pain are multiple and require a thorough examination in order to find the exact cause that triggers all symptoms and to establish the diagnosis. Indeed, the back of the foot is a complex part composed of several elements that can all be the cause of acute pain under the heel. To fully understand the different causes of heel pain, it is therefore important to be familiar with the anatomy of this part of the foot, which supports most of the body’s weight. The heel is therefore composed of the calcaneus, which is the large bone of this part of the foot, it rests on a fairly thick layer of fat which is itself covered by a thicker skin than on most of the body. Another essential element of the heel is the Achilles heel, which is a large tendon connected to the calcaneus and allowing it to be lifted. A final key element of the heel is the plantar aponeurosis, which connects the calcaneus to the toes.

    • Haglund’s disease
    • Haglund’s disease is a “bump” on the bone on the upper part of the back of the heel bone (calcaneus).
    • Achilles tendonitis
    • Insertional ossifying tenositis of Achilles
    • Retrocalcaneal bursitis

    Physical Examination

    Several diseases and injuries can affect some of these elements. This is the case of Sever’s disease, a pathology that can be linked to intense sports practice, but also simply to growth in children and adolescents. It consists of a rupture of the cartilage uniting the Achilles heel to the calcaneus. Another frequent cause of heel pain is Achilles heel tendonitis, which is generally due to a shock to the tendon, but can also result from overweight or insufficient hydration. Haglund’s disease, also known as runner’s disease, can also cause pain in the back of the heel. It is generally a condition that affects people involved in impact sports (soccer players, runners, etc.) and is manifested by bruising of the heel with a bump on the heel that is a sign of an enlarged calcaneus.

    In addition, plantar fasciitis can also cause pain in the back of the heels. There are two cases of plantar fasciitis: a long arch of the foot resulting in the phenomenon of “flat feet” and a short arch of the foot resulting in a foot that is too hollow. These two situations can lead to inflammation of the fascia. Finally, Lenoir’s thorn can also appear and cause this type of pain, which is a bone excrescence developing towards the plantar fascia. There are of course other possible causes for pain in this area such as a fractured calcaneus or Albert’s disease, but whatever the origin of the pain, it must be identified and treated.

    Consequences of heel pain

    The reason why it is so important to take pain behind the ankle and pain behind the heel so seriously is that the consequences of the diseases and injuries behind these symptoms are not insignificant. In addition to pain behind the heel, there may be inflammation of the tissue that makes the joint swollen and sensitive. In addition, if left untreated, these conditions can lead to lasting difficulty walking, as can be the case with plantar fasciitis. In fact, with plantar fasciitis, the pain may last several days and treatment will involve a lot of resting of this essential area for walking. Moreover, among the consequences of this type of condition, we can also mention the micro tears that accumulate as long as the appropriate treatment is not put in addition and will therefore take more and more time to resolve.

    How to treat heel pain

    In case of heel pain, it is therefore advisable to consult a qualified health professional such as the Podiatrist to determine the causes of the pain. The latter may proceed with an examination of the clinical foot to establish a diagnostic hypothesis, then biomechanical examinations and X-rays to confirm or refute the diagnosis before proposing an appropriate treatment. He will then be able to indicate how to reach it and define the most appropriate treatment protocol. Indeed, treating tendinitis does not necessarily involve the same procedures as for a fractured calcaneus, especially since there are multiple remedies.

    Thus, the health care professional may have to propose foot orthotics, custom-made insoles or custom-made shoes, as well as anti-inflammatory drugs to relieve pain. As his role is to provide advice and care, he may also recommend stretching after sports sessions or, on the contrary, resting the foot. In the most serious cases and after having exhausted milder options, it is also possible to proceed with surgery, particularly in situations of fractured calcaneus, which can cause serious after-effects and have consequences on the patient’s life afterwards. It is particularly to avoid reaching these extremities that it is essential in case of heel pain to make an appointment with a podiatrist as soon as possible in order to set up an adapted treatment quickly.

    Non-surgical treatment

    • The use of a moderate-heeled shoe or shoes
    • Custom-made foot orthotics
    • Strengthening the Achilles tendon
    • The immobilization
    • Calf stretching
    • Anti-inflammatory drugs
    • Weight loss

    You don’t have to live with the pain at the back of the heel. Contact our podiatric clinic in Montreal for treatment of the condition.


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      Podiatre Montréal
      1826 Sherbrooke O,
      Montreal, QC H3H 1E4