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What Is Calcaneus Pain?
The calcaneus, otherwise known as the heel bone, is the largest bone in your foot and the foundation of your entire lower limb biomechanics. When this area hurts, it can affect your mobility, daily activities and overall quality of life.
Calcaneus pain in the foot comes in many forms, from sharp stabbing sensations to dull throbbing aches that last all day. Many patients describe their calcaneus pain in the morning as the worst, feeling like they’re stepping on broken glass with their first steps out of bed. This morning stiffness is characteristic of several heel conditions and provides valuable diagnostic information about the cause of your discomfort.
Common Calcaneus Pain Causes
Heel pain is a common condition that affects people of all ages and activity levels. It can develop gradually or suddenly, and the pain can be mild or severe, persistent, and it can interfere with daily life.
Heel pain in adults and children can be caused by many factors, including overuse, structural abnormalities and underlying medical conditions.
Common causes include:
| Condition | About the Condition |
| Plantar Fasciitis | Inflammation of the plantar fascia, a thick band of tissue that connects the heel bone to the toes, often leads to plantar fasciitis, heel pain at the bottom of the heel. Plantar fasciitis pain is typically most severe in the morning or after periods of rest. This inflammation is usually caused by repetitive stress or overuse. |
| Achilles Tendinitis | Inflammation of the Achilles tendon at the back of the heel, caused by overuse or repetitive stress, can cause pain, particularly during activities such as running. |
| Heel Spurs | A bony outgrowth at the back of the heel bone, often caused by chronic mechanical irritation or repetitive stress. Heel spurs can irritate and inflame the surrounding tissue, causing discomfort and calcaneus pain when walking or standing for long periods. |
| Calcaneal Stress Fractures | Small cracks in the heel bone, caused by repetitive impact or overuse, lead to pain that worsens with activity and improves with rest. This is a common cause of calcaneus pain when running. |
| Bursitis | Inflammation of the bursa, a fluid-filled sac that cushions the heel, caused by repetitive motion or pressure, results in pain and swelling. |
| Tarsal Tunnel Syndrome | Compression of the tibial nerve as it passes through the tarsal tunnel, causing pain, tingling or numbness in the heel and foot. |
In children, heel pain in the back of the heel may be related to inflammation of the growth plate, also known as the calcaneal apophysis.
Biomechanical factors also play a significant role in the development of calcaneus pain. Flat feet, high arches, overpronation, or leg length discrepancies can all lead to abnormal stress patterns in the heel and foot, thereby predisposing individuals to various forms of heel pain.
Comprehensive Calcaneus Pain Treatment Approaches
There are many treatment options for calcaneal pain, depending on the underlying cause. Treatment strategies may include:
- Shockwave Therapy: This non-invasive treatment utilises sound waves to stimulate healing in the affected area, particularly effective for conditions such as plantar fasciitis and Achilles tendinitis.
- INDIBA® Activ Therapy: This radiofrequency therapy promotes tissue repair, reduces inflammation and helps in faster recovery.
- Rest and Activity Modification: Reducing or modifying activities that aggravate the pain can help alleviate symptoms and prevent further injury.
- Physical Therapy: A structured rehab program focusing on stretching and strengthening exercises can improve flexibility, reduce pain and enhance overall foot function.
- Orthotics: Custom or over-the-counter shoe inserts, including heel pads, can provide support, redistribute pressure, offer additional cushioning and alleviate stress on the heel.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.
- Ice Pack: Applying an ice pack to your heel several times a day can help reduce inflammation and alleviate pain associated with heel pain.
- Surgery: In severe or persistent cases, surgery may be necessary to address the underlying issue.
Monitor your heel for changes in pain, swelling or function and seek medical attention if the symptoms worsen or do not improve with conservative treatment.
Managing Morning Pain and Daily Activities
Calcaneus pain in the morning requires specific management strategies to help patients start their day with minimal discomfort. HelloPhysio’s physiotherapists usually recommend a series of gentle stretches done before getting out of bed, including ankle circles and calf stretches that can be done while lying down.
Proper footwear selection is key. Supportive shoes with adequate cushioning and arch support can distribute pressure more evenly across the foot. Custom orthotics or over-the-counter arch supports can provide additional relief for many patients.
Ice therapy after activities and heat application before stretching can help manage inflammation and improve tissue flexibility. The key is to time these interventions based on your symptoms and activity level.
Prevention Strategies and Long-term Management
Preventative measures, such as the following, can reduce the risk of developing calcaneus pain:
- Proper Footwear: Wearing shoes that provide adequate support and cushioning can help distribute pressure evenly across the foot.
- Stretching and Strengthening Exercises: Regular exercises targeting the foot and calf muscles can improve flexibility and strength, while also reducing the likelihood of injury.
- Gradual Increase in Activity: Slowly increasing the intensity and duration of physical activities allows the body to adapt and prevent overuse injuries.
- Weight Management: Maintaining a healthy weight reduces the stress on the feet and heels.
- Regular Check-ups: Periodic check-ups with a physiotherapist can help catch potential issues early and intervene in a timely manner.
The Bigger Picture Beyond Heel Pain
Heel pain can have a ripple effect on your overall foot health and quality of life. If left untreated, heel pain can become chronic, leading to ongoing discomfort, limited mobility, and even changes in your walking pattern. These changes can put additional stress on other parts of the body, such as the knees, hips, and lower back, leading to other uncomfortable and painful conditions.
The cause of heel pain may also impact your ability to be active, your physical fitness and your daily routines. If you are experiencing persistent or severe heel pain, seek medical advice to identify the underlying cause and start treatment. Addressing heel pain early can prevent long-term complications, improve your overall foot health and allow you to stay active and healthy.
When to See a Physiotherapist
If you’re experiencing heel pain for more than 2 weeks, it’s time to schedule an appointment with a physiotherapist. With the right treatment strategies, including physical therapy, orthotics, and advanced modalities such as Shockwave Therapy and INDIBA Activ Therapy, individuals can return to their activities quickly and safely.
If you are struggling with calcaneus pain, don’t let it control your life anymore. Contact HelloPhysio today to book an appointment and take the first step to pain-free movement.
