My feet are killing me. What can it be?

Heel pain is the major problem of adult people and active children between 8 until 13 years old, since people used their foot in almost all of daily activities. One of the daily activity is walking, foot also support our whole body to stand and moves. Because of their hard work, the possibilities of foot pain and injury that can be occurred on people are increasing.

One of the common problems that appear is heel pain which is caused by several reason, such as:

  • running,
  • tightness in calf muscle or Achilles tendon
  • shock absorption
  • shoes with bad arch support
  • a sudden inward/outward of  your heel
  • weigh bearing
  • awkward landing

Heel bones are the largest bones in human foot which directly contacts to the ground, bear your weight.

Basically, There are 2 categories of  pain in the heel; first is heel pain syndrome that is caused by low heels shoes or a suddenly increasing activities. Second is plantar fasciitis that is caused by biomechanical problem. Plantar fasciitis is the most common problem. It is caused by the tears and inflammation over the wide band of tendon and ligament that stretch from heel to the ball of foot. Long or short band tissue will cause low or high arch pain. People who experience plantar fasciitis will feel pain in their first step in the morning, it causes pain around the heel up to the arch.

Besides those two major categories that relate to pain in heel, they are also several condition that can be also possible to cause pain on human heels such as; Achilles tendinitis, bursitis, soft-tissue injuries, calcaneal spur, bone spur on heel or heel spur. Achilles tendinitis is caused by inflammation on large tendon, while bursitis is caused by inflammation on the back of the heels. Heel spur is caused by calcium deposit under bone heel without causing any symptoms. Calcaneal spur is caused by the pressure in sinew that creates bony projection on calcaneus.


People who have pain are recommended to take a rest at least for a week; Resting is a temporary treatment to relief the foot pain. Applying ice to the painful area and taking acetaminophen for pain and inflammation can be also suggested. Besides, there are also another treatment that can be considered such as
orthotics, wearing a proper shoes, plantar fascia and calf stretch, surgery is only suggested for patients who have heel spur, bursitis, neuroma, plantar
fasciitis and fail on nonsurgical treatment for more than a year . Foot pain in heel can be temporarily or chronic, that is why people who have foot
pain in heel
need treatment to make it less painful.

Pain in Heels of feet occurs in the heel that is the most common symptom for people who overuse its feet on heavy load or repetitively high impact exercise. Heel Pain is generally separated onto two kind of pain based on the area where the pain strikes, underneath the heel and back of heel.
Hence, these areas are locally responsible for causing some possibilities of the pain in heels of feet. Achilles Tendonitis, Retrocalcaneal Bursitis, and pump bump are the causes of the pain in back of heel. Otherwise, the most common pain in heels of feet happens at the beneath of heel.

Causes of heel pain

There are two conditions that stimulate the pain in heels of feet, plantar fasciitis and heel spur. Plantar fasciitis and heel spurs are both triggered by the inflammation of thick ligament called Plantar Fascia. The plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of
the calcaneus (heel bone) and extending along the sole of the foot towards the five toes. Plantar fasciitis is the painful inflammation of plantar fascia that
occurs when it is excessively stretched or flatted causing the small tears of fascia’s fibers, especially where the ligament attach to the heel bone.

This pain is triggered by the excessive and repetitive heavy pressure, improper shoes like high intensity of wearing women’s high heels, and the sudden weight gain. An accidental conditions associated with plantar fasciitis is the heel spur, a small bony growth where the fascia  is attached to the calcaneus (heel bone) which is existed because of the long-term plantar fasciitis.


The pain in heels of feet can be vary depends on it cause. Plantar fasciitis is in midway of underneath foot with the inflamed and swelled foot. You will feel
mild pain along the bottom of your foot but it will be flush up of your first step of the day. Besides, you will have difficulty in bending the foot. The heel spurs don’t always contribute pain. Heel spurs may cause the pain in heels of feet and tenderness in the bottom of heel and it can be worse for months.


Treatment should be taken for the plantar fasciitis include rest from heavy exercises that will stimulate the foot pain, cold therapy using the ice, stretching, proper shoes, and using anti-inflammatory medicines (NSAIDs) like ibuprofen and aspirin. If this treatment didn’t help at all, another pain relief foot orthotics and using night splint. Surgery is taken if the pain in the heel is getting more serious and abusive. Furthermore, the treatment of heel spur is similar with the main treatment of plantar fasciitis and wear heel pad shoe.

Pain in The Back of Heel is the common term to describe the pain occurring in the posterior of heel. Heel Pain is generally separated onto two kind of pain based on the area where the pain strikes, underneath the heel or back of heel. Underneath of heel pain is commonly due to the plantar fascia  and heel spurs. Plantar fasciitis and heel spurs are both triggered by the inflammation of thick ligament called Plantar Fascia. Another kind of heel pain is pain in the back of heel. This kind of foot pain is caused by the disorder of Achilles tendon which directly connects to both of calf muscles and calcaneus in the posterior of heel.

What causes pain in the back of the heel?

Pain in the back of heel exists because of several causes. The pain may be because of Achilles Tendonitis which is an inflammation of Achilles tendon. Achilles tendon is the largest tendon in the body that connects the calf muscle to the heel bone and important for normally daily activities like walking, running, and jumping. The overuse of Achilles tendon like excessive jumping during sports, activity’s significant increasing, and even sport’s injury can make the tendon becoming inflamed, painful, and swelling.

Furthermore, the other factors of this foot pain can come from the improper sport shoes, degenerated and weak calf muscles. Other cause of pain in the back
of heel is the retrocalcaneal bursitis. There are considerable bursa between the calf muscles and calcaneus and when the fluid inside the bursa is irritating, it will inflame and become extremely painful. Pump bump or posterior calcaneal exostosis is an abnormally bony enlargement that occurs in the back of heel. This bone spur can irritated either the soft or hard tissue surroundings and provide the pain in the back of heel.


The symptom of Achilles tendonitis is the pain grows shaper everyday and it becomes worse during the exercise. It can be seen from the foot’s physical look
like mild swelling near the tendon, stiffness, and tenderness to touch. Bursitis causes the pain in the back of heel and it’s getting worse if you stands for long time and bend your foot up or down. Otherwise, the pump bump can cause the pain and tenderness after suffering for several months, although it looks like everything is normal and not have any symptom at the beginning.


Treatment for the pain of the back of heel depends on its causes. Treatment for Achilles Tendonitis can be vary depends on its severity, the main treatment
is trying to put ice over the tendon for 15-20 minutes, decrease of stop the heavy activity, changing the shoes to the fit in shoes, and use the NSAIDs like
ibuprofen. The Retrocalcaneal bursitis’s first treatment is just similar to the Achilles Tendonitis, using ice, stretching, and taking the NSAIDs.

If these measures don’t work out at all for Achilles tendonitis and retrocalcaneal bursitis, meeting the foot orthotics can be considered for
reducing the pain in the back of heel. The surgery will need if the orthotics can’t be the pain relief. The doctor will removed the patient’s inflamed tissue and abnormal areas tendon such as a growth extra bones. The surgery is just for pain relief not for healing the causes of heel pain, so it is necessary to regularly see the orthotics for make up the tendon and eliminate the cause of pain in the back of heel.

Top of foot pain  is the common term to explain about pain that occurs in the forefoot caused by several factors that happen along the running activity. The pain runs over the metatarsal bones to the toes and creates either the sharp or dull pain on the forefoot depending how severe the injuries is. The Pain at Top of Foot problems can actually happen in the different part of foot, the toes, the forefoot, and the hind foot. The hind foot pain for example, occurs in the back of the foot extending from the heel to the ball of foot. One of the general foot pain of hind foot are plantar fasciitis that caused by the inflammation of fascia on
the back of foot. The top of foot pain running that creates the instability on forefoot and midway foot may cause the plantar fasciitis.

There are some reasons why top of foot pain often strikes the runners. Those are the improper running shoes, structural flaw of footstep, and even the error training of shoe to barefoot running. Wearing the improper running shoes that do not fully fit in and tightly tied can hurt the top of foot bones and some small movement flaws along running activity can caused the high impact that the top of foot pain running will be gradually exist. Many runners believe that barefoot running gives the best shot as it’s proven that can strengthen the muscles and accelerate the running stride, but the sudden migration from the using footwear running without any right procedures of barefoot training can enforce any acute injuries.

Some top of foot pain running injury that commonly happen among runners are extensor tendonitis and metatarsal stress fracture. Extensor Tendonitis is the
inflammation of tendons on the top surface of foot caused by the tightness of the calf muscles that release the excessive stress to the top of foot.


The treatment of this kind of top of foot pain running are from using the anti-inflammatory medicines, stretching the calf muscles for first aid and seeing the orthotics if the foot pain is getting serious. Another top of foot pain running is the stress fracture. Stress fracture is a small crack of bones because of the overtired muscles. The overuse of foot on running causes the repetitive stress on muscles and muscles transfers the stress to the bones creating the fractures. The symptoms of stress fracture are the swelling of top of foot and ankle, sharp pain during the daily activity, and tenderness to pressure on the top surface of metatarsal bone.

The top of foot pain running can’t be ignored as the bone can crack completely so it should be relieve by having some treatments. How to heal and
treat the foot of pin running is depending on its severity. If it’s still a light pain, the first aid is trying to put some anti-inflammatory medicines on the swelling foot pain and keep your feet of from the pressure of your weight. Using the proper running shoes with the stiffer sole can also help dealing with stress fracture. Metatarsal stress fracture can’t heal by your own so that seeing the professional podiatrist can helpthe  recovering process.

Remember, this infomrtaion does not replace professional advice. You should see The Podiatrist if you have any of the above problems, or any other foot problems.



About Your feet and podiatry with Caron Orelowitz | Registered Podiatrist - Auckland

Caron Orelowitz was born in Johannesburg and emigrated to New Zealand in 1997. She studied Podiatry at The Witwatersrand Technikon and was in private practice in South Africa for a few years, before setting off to ‘the other side of the world’. Auckland Podiatry. Since 1998 she has been helping people of all ages who have problems with their feet, from the elderly, to sports people, and those who just want some TLC for the feet. At present she has 5 practices (with a satellite Diabetes Practice out West Auckland), owns a children’s shoe shop (Scooters in Remuera), and tries to fit in some exercise when time permits. Caron is an active member of Podiatry New Zealand (NZ), and holds the position of Treasurer for the Auckland Branch, as well as representing the Northern Region on the Executive Council. She is registered under HPCAA (Health Practitioner Competency Assurance Act), and is often seen attending (and organizing) Seminars and workshops. Caron has a special interest in Paediatrics and can often be seen on the floor showing children some exercises. ACC registered Discounts for Super Gold Card Holders, members of Grey Power and Green Prescription participants.

Posted on November 17, 2014, in What is a Podiatrist, Your feet. Bookmark the permalink. Leave a comment.

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