Prevention

You can help to prevent heel pain by maintaining a healthy weight, by warming up before participating in sports and by wearing shoes that support the arch and cushion the heel. If you are prone to episodes of plantar fasciitis, exercises that stretch the Achilles tendon (heel cord) and plantar fascia may help to prevent the area from being injured again. You also can massage the sole of your foot with ice after stressful athletic activities. Sometimes, the only intervention needed is a brief period of rest and getting new walking or running shoes.

Treatment

Treatment of heel pain depends on its cause:

• Plantar fasciitis - Most doctors recommend a six- to eight-week program of conservative treatment, including a temporary rest from sports that trigger the foot problem, stretching exercises, ice massage to the sole of the foot, footwear modifications, taping of the sole of the injured foot, and acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen (Advil, Motrin and others) for pain. If this conservative treatment doesn't help, your doctor may recommend that you wear a night splint or a short leg cast, or he or she may inject corticosteroid medication into the painful area. Surgery is rarely necessary and is not always successful.

• Heel spur - Conservative treatment includes the use of shoe supports (either a heel raise or a donut-shaped heel cushion) and a limited number of local corticosteroid injections (usually up to three per year). As in plantar fasciitis, surgery is a last resort.

• Calcaneal apophysitis - This condition usually goes away on its own. In the meantime, conservative treatment includes rest and the use of heel pads and heel cushions.

• Bursitis - Treatment is similar to the treatment of heel spurs. Changing the type of footwear may be essential.

• Pump bump - Treatment is similar to the treatment of bursitis and heel spurs. In rare cases, the bony growth at the heel may need to be removed surgically.

• Local bruises - Heel bruises can be treated by applying an ice pack for the first few minutes after injury.

• Achilles tendonitis - This condition is treated conservatively with rest, NSAIDs and physical therapy.

• Trapped nerve - If a sprain, fracture or other injury has caused the trapped nerve, this underlying problem must be treated first. In rare cases, surgery may be done to release the trapped nerve.