General Question

Seek's avatar

What is causing the pain in his heel?

Asked by Seek (34800points) April 30th, 2010

My husband is a healthy 40 year old man. He’s 5’10, 250 lbs. He’s done hardwood flooring for ten years, used to build cell-phone towers, and has pretty much always been in construction.

Recently, he’s been experiencing a sharp pain in the heel of his right foot. It hurts in the entire heel, but is worst in the center, just below the arch. The pain comes in waves, and at its worst rates between a 6 and 7.

The pain is worse at the end of the day, and resting (when he can get it) helps somewhat. Sometimes it gets so bad he can barely walk.

Since we don’t have health insurance, he’s let this go for as long as he could – but it’s becoming unbearable.

We are hoping to get an idea as to what could be causing the pain, in hopes of keeping the diagnostic costs down.

Any help? Thanks!

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31 Answers

slick44's avatar

Sounds like heel spurs.

sleepdoc's avatar

Not knowing any more than what you wrote here I am going to just mention 2 of the frequent causes of heel pain. Plantar fascitis (which this could be) often is pretty intense and seems to be at its worst after activity. Many times it does get better with rest. The other frequent cause is a bone spur. I am not sure what the difference costwise is seeing your regular Dr. and seeing a podiatrist would be. Podiatrists are foot specialists though so the source might get picked up earlier.

thriftymaid's avatar

My guess (and that’s all it is) is what escapedone7 said; plantar fascitis. I’ve had it and it is killer pain. See a podiatrist regardless. (note: check with your insurance company; some do not cover podiatrist services)

bummer's avatar

Looks like you have received excellent suggestions. Pinched nerve in the lower back area and gout should also be asked about. Good luck!

thriftymaid's avatar

@sleepdoc My experience was that the pain was the worst after being off feet. That first step in the morning was brutal.

Cruiser's avatar

Aside from the great suggestions above, him being on his hands a knees all day long puts a lot of stress on the back and hamstrings. Does he stretch or exercise? That will help counteract the stress on his knees and back.

I would suggest he lay on the floor on his back and rest his feet, calves on a couch and just let his lower back relax into the floor for 15–20 minutes a night. Also you could have him lay on the floor with his legs/feet 90 degrees up in the air and rest them against your belly while you stand there to support his legs. Fold your arms and rest them across his feet and gently apply your upper body weight down on his legs and stretch his feet to lengthen his ham string muscles. This should feel comfortable and if there is any sharp pain stop immediately and see a back specialist or his Doctor.

stranger_in_a_strange_land's avatar

These symptoms sound a lot like plantar fasciitis to me. I was treated for it in the Army about 25 years ago, fortunately no surgery.

I know you have sucky insurance, so try these things first: Get the elastic-type athletic tape and strap it tightly across the heel and instep. Also get the shoe inserts that are filled with a gelatin material. I eventually had to get orthotic boot inserts, but these are the experiments the doctors did before that.

If these don’t work, then it’s likely heel spurs, which have to be diagnosed with x-ray and possibly treated by surgery.

asmonet's avatar

Sounds like what I have, plantar fasciitis and achilles tendinitis.
Welcome to hell.

I’m leaning more towards plantar if the pain is more forward in his foot. Not the back of the heel, but near the arch like you said.

You’ll likely need to get him some inserts for his shoes that have been molded to his feet by a doctor. This will help tremendously with the pain, but may hurt worse while he gets used to it.

Just be glad he didn’t get it when he was fourteen, like me. And I still have it.

FireMadeFlesh's avatar

As many others have said, plantar fasciitis is your best bet considering it is worse at the end of the day, since it would be aggravated all day. A calcaneal spur is somewhat less likely given the location you have described, as spur pain is at the point where the heel meets the ground.

@bummer A pinched spinal nerve would cause pain for all areas it innervates, while gout primarily produces pain in joints, particularly the interphalangeal and metatarso-phalangeal joints. Both of these are very unlikely given the stated clinical history.

TILA_ABs_NoMore's avatar

Sounds like plantar fascitis to me. I have it. The only thing that helps me are steroid injections, although they’re not very good for you (increases chance of rupture). But it was definitely worth it for me

sleepdoc's avatar

@TILA ABS NoMore… there are some other things out there now for it

Scooby's avatar

WOW talk a bout coincidences! I have had the same pain in my right heel & foot these last few days, I was going to go see my Quack…. Great question :-)

ubersiren's avatar

If it’s just on the heel, I don’t know that it’s plantar fascitis. I also have PF. That more covers the arch of the foot as well as the heel. If it’s concentrated on the heel and it’s sharp, I’d suspect heel spur. Is it worse in the morning when he first tries to walk? That’s what PF is like… although that doesn’t necessarily mean it’s not something else.

If it’s PF, massage could help. You should see a podiatrist about heel spurs.

Edit: I see that you’ve said it’s worse at the end of the day and the pain comes in waves. I suspect heel spur.

TILA_ABs_NoMore's avatar

@sleepdoc I should look into to that. The injections are just an easy fix because the pain relief is almost immediate…but the damage that they cause might make me kick myself in that ass later. That and there expensive as hell and that’s WITH insurance. Might not be the best solution @Seek_Kolinahr I suppose.

@ubersiren I only have it in one heel. Though your right it still could be a heel spur.

sleepdoc's avatar

@TILA ABs NoMore… there are a few using ultrasound and soundwave to treat now

TILA_ABs_NoMore's avatar

@sleepdoc Really? Does it fix the problem or is it just for pain management?

sleepdoc's avatar

@TILA_ABs_NoMore… I think it depends on the patient and how sever it is

BoBo1946's avatar

@slick44 gets my vote!

Silhouette's avatar

His arches could be falling, try arch supports and see if they help. They are very inexpensive.

BoBo1946's avatar

here is a great link…

Heel Pain Treatment and Tips for Heel Pain ReliefDon’t let the foot pain of a heel spur or plantar fasciitis defeat you. Learn to beat your foot pain. – Cached – Similar

slick44's avatar

Better a pain in the heel, then a pain in the ass!

zophu's avatar

It could be from a problem further up the leg, up to the hips or back. Try stretching the lower back and legs and see if the pain reacts. When I was having back problems as a kid, intense pain would develop in my heal much like how you describe. As I aligned my pelvis, the pain went away completely over a week. Your husband might have a similar problem.

jazmina88's avatar

i was going to say plantars fascitis as well. go to the walking company. get orthotics and a couple paris of shoes. $400 and he will feel better.

Jeruba's avatar

I’d bet on plantar fasciitis too, but of course you need a doctor’s diagnosis.

My x-rays, taken later for another reason, showed some pretty impressive heel spurs, but they don’t hurt at all. It was the fasciiitis. It went away after a year of babying. The babying consisted mainly of soft, supportive inserts inside my shoes; I had to buy comfortable shoes a half size larger. I also took pain meds, but I probably could have stopped them much sooner. Also avoiding doing things that made it hurt, such as brisk walking for exercise, seemed like logical advice. I kept that up for some time after the pain began (let’s hear it for denial).

If he is overweight, that can contribute to the problem.

The doctor who took the x-rays told me that some docs use the dramatic sight of the heel spurs to encourage unnecessary surgery when they may not actually cause you any trouble.

FireMadeFlesh's avatar

@Jeruba Which country do you live in? Do doctors actually take the x-rays there?

Jeruba's avatar

I’m in the U.S. Califfornia. Some doctors’ offices and clinics have onsite x-ray capabilities or share quarters with a radiology facility. My podiatrist has his own in-office x-ray setup, and my orthopedist has access to one on the premises. In most cases, though, it’s necessary to go out to a radiology lab and wait for the results to come to the doctor.

The doctors don’t perform the procedure themselves, of course. A technician does that.

FireMadeFlesh's avatar

Thanks for clarifying, your original wording confused me a bit.

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