What can cause heel pain?

Q. What can cause heel pain?

Answered by
Dr. Akshay Kumar Saxena
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 02, 2016 and last reviewed on: Jul 25, 2023

Hi doctor,

I am a 67-year-old male. I am overweight, mildly diabetic, and have a high BP. I have pain in the backside of my left heel. It increases in the evening. I think I have Achilles tendinitis. Please help.



Welcome to icliniq.com.

You have mentioned pain in your heel region. Also, you have stated that you are diabetic, hypertensive, and overweight. There are actually many causes of pain in the heel region, so it can be due to plantar fasciitis which is very common in your age group. It can be due to bony spurs causing recurrent inflammation. As you have stated it can also be due to Achilles tendonitis (Achilles tendinitis) which is an inflammatory condition at the site of attachment of the Achilles tendon. Also, sugar levels have to be kept under strict control because it can sometimes lead to cellulitis like a situation in which a patient experiences pain, swelling, local warmth, etc., and treatment is entirely different for it. So, the treatment depends upon the cause of the pain. Also kindly tell me whether there is any swelling or any other signs and symptoms of inflammation like skin discoloration or local warmth etc. Initially, if the pain is of recent origin with no other signs and symptoms of inflammation as written earlier, you can initiate with ice packs for local application at the tender site. Physical therapy especially ultrasonic for local application or laser therapy can be initiated. Take gentle painkillers like the tablet Ultracet (Tramadol hydrochloride and Acetaminophen) twice a day for three to five days. Shoe modification and avoidance of those activities which increase your pain. Do let me know how you are feeling in the next three to five days and revert back with your investigation reports and a clinical picture.

Thank you.

Investigations to be done:

1. Recent blood tests like CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein) and serum uric acid.

2. X-ray ankle - lateral view.

3. A clinical picture showing exact site of pain and inflammation, so that the pathology can be estimated.

Differential diagnosis:

1. Achilles tendonitis (Achilles tendinitis).

2. Plantar Fasciitis.

3. Bony spurs.

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