While heel pain and Plantar Fasciitis can be the direct result of sports injuries or foot trauma, it’s also common for these conditions to develop in the absence of a dramatic or sudden impetus.

In fact, heel pain that onsets gradually can be even more insidious–since it may be mild at first, and easier to brush off as insignificant. However, if the factors causing your heel pain persists over time, you may be setting yourself up for a long road to recovery, or even long-term damage.

In the blog post, we’ll explore some of the most common causes of heel pain that develops seemingly out of the blue. We’ll also cover conservative treatment options that have been proven to both treat and prevent heel pain:

Plantar Fasciitis Without Injury

While Plantar Fasciitis isn’t the only reason that heel pain may develop in the absence of trauma or injury, it’s certainly the most common. The American Academy of Family Physicians lists Plantar Fasciitis as the number one cause of heel pain and estimates that more than 2 million people seek treatment for the condition each year.

Plantar Fasciitis that develops gradually over time is typically caused by the following factors:

Obesity or Rapid Weight Gain:

The arch of the foot exists to absorb and distribute the impact from running, walking, and jumping. However, with excess weight comes an additional burden to the arch. Pregnancy or rapid weight gain can cause damage and cumulative strain to an unsupported arch.

The Aging Process:

As we get older, our arches naturally decrease in flexibility and strength, making them more susceptible to small tears, flattening, strain, and degeneration.

Excessive Pronation or Underpronation:

Irregularities in gait, such as underpronation or pronation (conditions that cause of the foot to roll outward or inward while you walk), can damage or strain the arch of the foot over time.

Ill-Fitting or Unsupportive Footwear:

Your shoes can make a big difference in how your arch absorbs and distributes impact. Footwear that doesn’t fit properly or support and cushion your arch can lead to Plantar Fasciitis over time.

Work Conditions or Exercise Regimens:

Whether you’re on your feet, walking, or running a lot for work or exercise, this wear and tear can have a cumulative effect in straining or breaking down your arch unless it is properly cushioned and supported.

Other Causes of Heel Pain Without Trauma

Numerous conditions that cause heel pain can develop in the absence of trauma or injury. Most of these conditions develop gradually over time, due to unsupportive or worn footwear, carrying extra weight that places strain on the heel and arch, or simply wear and tear from overuse.

Bursitis of the Heel:

Bursitis develops when the retrocalcaneal bursa, or the fluid-filled sacs that cushion and lubricate the back of the heel, become inflamed and irritated through rubbing or pressure over time. Bursitis results in pain at the back of the heel (where the heel meets the Achilles tendon), inflammation, redness, and tenderness.
Learn More About Bursitis of the Heel.

Tarsal Tunnel Syndrome:

Tarsal Tunnel Syndrome is similar to carpal tunnel syndrome–except the condition develops in the feet. When the tibial nerve is pinched or obstructed over time, the amount of blood flow to this nerve decreases and results in pain and inflammation. The condition often develops in tandem with arthritis, obesity, or heel spurs.
Learn More About Tarsal Tunnel Syndrome.

Haglund’s Deformity:

This condition is also known as “pump bump,” and causes a painful lump to form on the back of the heel. Haglund’s Deformity is usually caused by prolonged use of unsupportive shoes like high heels.
Learn More About Haglund’s Deformity.

Posterior Tibial Tendonitis:

If your heel pain is primarily located on the inside of the foot, ankle, shin, or heel, you may have posterior tibial tendonitis. The condition develops over time in response to overuse and irritation of the posterior tibial tendon. You may have this condition if standing on one foot while trying to lift your heel off the ground is extremely painful.
Learn More About Posterior Tibial Tendonitis.

Treating Heel Pain and Plantar Fasciitis

Whether your heel pain is related to Plantar Fasciitis, posterior tibial tendonitis, or Haglund’s Deformity, the most important steps you can take toward healing are identifying the causes of your pain (for example, ill-fitting or unsupportive footwear), then taking consistent and proactive steps to relieve your pain and promote healing.

While chronic or severe heel pain that does not respond to conservative treatments may require more invasive or expensive medical interventions, most cases of heel pain–particularly cases of Plantar Fasciitis–can be treated successfully and inexpensively at home:

Icing

To reduce redness, inflammation, pain, or swelling, apply an ice pack for twenty minutes, two or three times each day.

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

NSAIDs like Ibuprofen can reduce swelling and pain, making you more comfortable while you recover and rest.

Rest

The importance of rest can’t be overstated, particularly if your heel pain is being caused by overuse. Set a schedule of rest breaks several times a day, sitting or lying down, taking the pressure off your heel and arch. Rest will help facilitate the healing of Plantar Fascia of micro-injuries and allow the arch to “bounce back” over time.

Stretching

Simple stretches, performed once or twice a day for 10-15 minutes can improve the strength and flexibility of the Plantar Fascia ligament and surrounding muscles and tissue. A strong, flexible arch is an arch that can withstand greater impact and weight!

Replace or Retire Your Worn or Unsupportive Footwear

Those red high heels might be snazzy, but they aren’t worth long-term pain and damage to the arch of your foot. Reserve unsupportive footwear for infrequent, short-term activities, replace worn shoes, and fortify your flats with additional arch support in the form of orthotic inserts.

Orthotic Support

Orthotic inserts such as Heel Seats were made especially for Plantar Fasciitis. These inserts can add additional arch support and cushioning to almost any pair of shoes, and lift the arch to an optimal level for absorbing impact and distributing weight.

Remember, while your heel pain has seemingly appeared suddenly and mysteriously, the cause has likely been brewing for some time as a result of weight gain, an unbalanced gait, improper footwear, or a weak arch. Keep this fact in mind as you approach conservative treatment options like icing, stretching, orthotics, and rest. These remedies won’t fix the problem overnight. However, with patience, consistency, and time, more than 90 percent of plantar fasciitis cases can be resolved successfully without medical intervention.