Oxford’s specialists for advanced podiatric medicine and surgery.

The Foot Doctor specializes in the treatment of diabetic foot care and routine foot pain. Let us help you get back on your feet again.

Causes

Athlete’s foot is caused by the same type of fungus that causes ringworm and jock itch. Damp socks and shoes and warm, humid conditions favor the organisms’ growth.

Athlete’s foot is contagious and can be spread by contact with an infected person or from contact with contaminated surfaces, such as towels, floors and shoes.

Risk factors

You are at higher risk of athlete’s foot if you:

  • Are a man
  • Frequently wear damp socks or tightfitting shoes
  • Share mats, rugs, bed linens, clothes or shoes with someone who has a fungal infection
  • Walk barefoot in public areas where the infection can spread, such as locker rooms, saunas, swimming pools, communal baths and showers

Complications

Your athlete’s foot infection can spread to other parts of your body, including:

  • Your hand. People who scratch or pick at the infected parts of their feet may develop a similar infection in one of their hands.
  • Your nails. The fungi associated with athlete’s foot can also infect your toenails, a location that tends to be more resistant to treatment.
  • Your groin. Jock itch is often caused by the same fungus that results in athlete’s foot. It’s common for the infection to spread from the feet to the groin as the fungus can travel on your hands or on a towel.

Prevention

These tips can help you avoid athlete’s foot or ease the symptoms if infection occurs:

  • Keep your feet dry, especially between your toes. Go barefoot to let your feet air out as much as possible when you’re home. Dry between your toes after a bath or shower.
  • Change socks regularly. If your feet get very sweaty, change your socks twice a day.
  • Wear light, well-ventilated shoes. Avoid shoes made of synthetic material, such as vinyl or rubber.
  • Alternate pairs of shoes. Don’t wear the same pair every day so that you give your shoes time to dry after each use.
  • Protect your feet in public places. Wear waterproof sandals or shoes around public pools, showers and lockers rooms.
  • Treat your feet. Use powder, preferably antifungal, on your feet daily.
  • Don’t share shoes. Sharing risks spreading a fungal infection.

Where does heel pain develop?

You might experience pain, soreness or tenderness anywhere in the heel. You typically feel heel pain:

  • Behind the heel.
  • Beneath the heel.
  • Within the heel bone itself.

What causes pain behind the heel?

Several problems can cause pain to develop in the back of the heel:

  • Achilles tendinitis: The Achilles tendon is a fibrous tissue that connects the calf muscle to the heel bone. It’s the body’s longest and strongest tendon. Runners and basketball players are more prone to Achilles tendinitis. This overuse injury inflames the tendon. Tendonitis causes pain, swelling and stiffness in the back of the heel.
  • Bursitis: Bursitis occurs when fluid-filled sacs called bursae (plural of bursa) swell. These sacs cushion joints, allowing for fluid movement. You may have a tender, bruise-like feeling in the back of the heel. Bursitis typically occurs after you spend a lot of time on your feet.
  • Haglund’s deformity: Chronic inflammation and irritation can cause an enlarged bony bump (called a pump bump) to form in the back of the heel. Shoes with higher heels, such as pumps, can make the bump and pain worse.
  • Sever’s disease (calcaneal apophysitis): Sever’s disease is a frequent cause of heel pain in active children between 8 and 14. Kids who participate in activities that require a lot of running and jumping are more prone to this problem. The increased athletic activity irritates the growth plate in the back of the heel.

What are the symptoms of heel pain?

Heel pain symptoms vary depending on the cause. In addition to pain, you may experience:

  • Bony growth on the heel.
  • Discoloration (bruising or redness).
  • Stiffness.
  • Swelling.
  • Tenderness.
  • Pain after standing from a resting/sitting position.

How is heel pain diagnosed?

Your healthcare provider will assess your symptoms and perform a physical exam. You may also get X-rays to check for arthritis, bone fractures, bone alignment and joint damage.

Rarely, you may need an MRI or ultrasound. These can show soft tissue problems which X-rays don’t reveal.

What are the complications of heel pain?

Heel pain can interfere with your ability to get around, work, exercise and complete daily tasks. When it hurts to move, you can become sedentary. An inactive lifestyle can lead to weight gain. You may also become depressed because you can’t do the things you love.

Untreated Achilles tendonitis can cause the tendon to break down (tendinosis). In time, the Achilles tendon can tear or rupture. This problem may require surgery.

How is heel pain managed or treated?

Most problems that cause heel pain get better over time with nonsurgical treatments. Therapies focus on easing pain and inflammation, improving foot flexibility and minimizing stress and strain on the heel. These treatments include:

  • Injections: Steroid injections can ease pain and swelling. Steroid injections should rarely, if ever, be given for a tendon problem but may certainly help for plantar fasciitis and bursitis.
  • Orthotic devices: Over-the-counter or custom-made shoe inserts (orthotics) can take pressure off the heel. Some people find relief by wearing a splint at night, especially if they get morning pain. A walking boot may be necessary for more severe symptoms. You may also need to switch to more supportive shoes for everyday wear and exercise.
  • Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) combined with ice packs ease pain and swelling.
  • Physical therapy: Massage, physical therapy and ultrasound therapy can break up soft tissue adhesions. These treatments may reduce pain and inflammation.
  • Stretching exercises: Your healthcare provider can show you how to do heel stretching exercises for tight tendons and muscles.
  • Taping: You can use athletic or medical tape to support the foot arch or heel.

It’s rare to need surgery to treat most causes of heel pain.

How can I prevent heel pain?

To prevent heel pain or keep pain from returning, it’s important to keep your foot and heel tendons flexible. You should stretch regularly and wear properly fitted, supportive shoes. Runners are especially prone to heel pain. You can prevent running injuries by covering fewer miles and running on softer surfaces.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

  • What is causing my heel pain?
  • What is the best treatment for me?
  • What can I do to lower the risk of getting heel pain again?
  • What types of symptoms need more urgent evaluation?

A note from Cleveland Clinic

Heel pain often improves over time with nonsurgical treatments. Your healthcare provider can determine what’s causing the pain. Your provider can also show you stretching exercises and recommend orthotics and other methods if needed. Many people try to ignore heel pain and continue with activities that make the problem worse. But it’s essential to give your body time to recover. Otherwise, you may develop chronic heel pain that sidelines you for an extended time. The longer you have heel pain the harder it is to effectively treat, so it’s important to get evaluated.

What is the prognosis (outlook) for people who have heel pain?

Heel pain typically goes away with nonsurgical treatments, but recovery takes time. You need to be patient and give your body time to mend. If you return to your usual activities too quickly, it can set back your recovery. In rare situations, you may need surgery.

When should I call the doctor?

You should call your healthcare provider if you experience:

  • Pain that doesn’t improve in a few weeks with rest or pain relievers.
  • Pain that makes walking or movement difficult.
  • Severe foot or heel swelling, inflammation or stiffness.

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