Pain on one or both sides of the heel, without redness or swelling, causing difficulty walking, is known as heel pain. It is one of the common ailments among middle-aged and elderly individuals. Many people assume that heel pain is caused by heel spurs, but this view is not entirely accurate.
We once conducted an experiment: all participants with heel pain stood with soles touching and had lateral X-rays taken of both heels. The results showed that many people had no bone spurs (osteophytes) on the heel side where they experienced pain, while the pain-free side exhibited bone spurs.Of course, some cases matched perfectly. This indicates that heel pain isn't necessarily caused by heel spurs, and individuals with heel spurs may not necessarily experience heel pain.
In reality, various pathologies in the heel region—including bone, joints, bursae, and fascia—can cause heel pain. The most common culprit is plantar fasciitis. This is a non-infectious inflammation characterized by pronounced pain upon waking in the morning, worsening with walking, and persisting for extended periods.
The plantar fascia is a triangular-shaped tendinous membrane beneath the foot's soft tissues. Its narrow posterior end attaches to the calcaneal tuberosity, while its anterior end fans out toward the toes. Its primary function is to maintain the foot arch, providing elasticity and absorbing the ground reaction forces when the foot strikes the ground during walking. Overuse or abnormal tension can lead to inflammation.Plantar fasciitis commonly affects individuals who stand or walk extensively, representing a chronic mild injury. Pain typically localizes near the heel on the sole. Lateral heel X-rays may reveal bone spurs forming at the medial attachment site beneath the calcaneus or show thickening and increased density of the heel fascia. However, the presence or absence of calcaneal spurs alone does not aid in diagnosing plantar fasciitis.Treatment for heel pain includes both medication and non-medication approaches, with physical therapy being the primary non-medication method. This should be tailored to each individual's specific circumstances.