Click here to read our Covid policy.
Skip to main content

Little-Known Causes of Chronic Heel Pain

Little-Known Causes of Chronic Heel Pain

Heel pain can be hard, if not impossible, to ignore, but the only way to really treat heel pain is to address the root cause.

Plantar fasciitis and heel spurs are common causes of chronic heel pain, but our team of board-certified podiatrists knows they aren’t the only potential causes.

Here at Manhattan Podiatry Associates, PC, in Midtown and Downtown Manhattan, we treat common and not-so-common causes of heel pain. If you’re struggling with chronic pain, don’t hesitate to reach out. 

In the meantime, here are eight lesser-known causes of chronic heel pain.

1. Baxter’s nerve entrapment

Often overshadowed by plantar fasciitis, Baxter's nerve entrapment involves compression of your inferior calcaneal nerve, which is the first branch of your lateral plantar nerve.

If this nerve becomes compressed, it can lead to chronic heel pain, tingling, and numbness. It's responsible for 20% of cases of heel pain, making it the second most common cause of heel pain after plantar fasciitis. 

2. Tarsal tunnel syndrome

You’ve likely heard of carpal tunnel syndrome in your wrist. Tarsal tunnel syndrome is similar. Both conditions involve the compression of a nerve. In this case, though, it’s the posterior tibial nerve in your ankle that’s compressed.

About 43% of people with tarsal tunnel syndrome have a history of ankle trauma, such as ankle sprains.

3. Reactive arthritis

Reactive arthritis is an autoimmune condition that can cause inflammation in various joints, including those in your feet. Chronic heel pain may be a manifestation of reactive arthritis, especially where your tendon meets your bone (enthesitis).

4. Peripheral neuropathy

While often associated with diabetes, peripheral neuropathy can also result from other underlying conditions. Nerve damage in your feet can lead to chronic heel pain.

5. Fat pad atrophy

The fat pad in your heel serves as a natural cushion, but unfortunately, it can waste away (atrophy) over time. Also known as heel fat pad syndrome, this condition can develop from weight gain, trauma to your fat pad, repetitive activities, gait imbalance, and wearing inappropriate footwear.

6. Calcaneal fractures

Stress fractures in your heel bone (aka your calcaneus) can be a source of persistent heel pain. These fractures may develop gradually over time due to repetitive stress, and imaging tests such as X-rays can confirm their presence. Long-distance runners, dancers, and soccer players are most at risk for calcaneal stress fractures. 

Other types of calcaneal fractures include compound fractures and avulsion fractures. Unlike stress fractures, these may occur more suddenly. 

7. Systemic conditions

Conditions such as rheumatoid arthritis and systemic lupus erythematosus can manifest with joint pain, including chronic heel pain. 

8. Cysts

Rarely, a calcaneal bone cyst may be the source of your heel pain. They occur only at a rate of 2-3%, and while they're benign, surgery may be considered to help maintain the integrity of your bone. 

What is causing your heel pain and what can you do about it?

Diagnosing heel pain requires a physical exam, a review of your symptoms, and in some cases, imaging tests, such as X-rays. Our team utilizes advanced technology like the Esaote O-Scan MRI when possible to help make the most accurate diagnosis 一 especially when working with less common causes of heel pain.

Once the source of your pain is confirmed, our team creates a treatment plan to help eliminate your pain. Depending on the underlying cause, you may benefit from extracorporeal shock wave treatment, pulse dye laser, gait analysis, custom orthotics, physical therapy, medication, or lifestyle modifications.

Help for your foot pain is just a call or click away. Schedule your appointment with our team today!

You Might Also Enjoy...

When to See a Podiatrist About Your Neuroma

When to See a Podiatrist About Your Neuroma

Neuromas can feel like you’re walking around with a pebble in your shoe, but does that mean it’s time to see a podiatrist? Yep! That’s just one of seven signs that it’s time to seek podiatric care. Read on to learn more.
7 Treatments for Common Ligament Injuries

7 Treatments for Common Ligament Injuries

Ligament injuries are one of the most common orthopedic injuries and, unfortunately, can quickly zap your quality of life. Read on as we share seven treatments for the most common ligament injuries.

5 Risk Factors for Severe Bunion Pain

If you already have a bunion, you may want to know the risk factors for severe bunion pain. Read on to find out what can exacerbate bunion pain and 一 most importantly 一 what you can do to find relief.
How to Ease Your Gout Flare-Up

How to Ease Your Gout Flare-Up

Gout flare-ups are notorious for causing intense pain, and if you’re currently dealing with one, there’s likely one thing on your mind: how to ease your discomfort. Read on to learn tips and tricks for easing your gout flare-up.
How to Manage Pain After Twisting Your Ankle

How to Manage Pain After Twisting Your Ankle

Sprained ankles are a common and, unfortunately, rather painful injury. The good news is there are steps you can take right away to help manage your pain. Read on to learn at-home pain management tips and how we can help you manage long-term pain.