What Causes Heel Pain?

Ankylosing Spondylitis

Ankylosing spondylitis is a type of arthritis that affects the spine. It produces inflammation and causes the vertebrae to gradually fuse together. This condition is more common in men, and symptoms generally start in early adulthood. Patients with ankylosing spondylitis have reduced flexibility in the spine, and they may adopt a posture that hunches forward. If the condition affects the patient's ribs, it might become difficult to take deep breaths. In addition to the spine, the hips, shoulders, and heels are often affected. At first, symptoms may only be present in the morning or after periods of inactivity. They may worsen over time, and some patients experience temporary remission or improvements in symptoms as well. Doctors will perform a physical exam and imaging studies to diagnose ankylosing spondylitis.

During the exam, the patient will be asked to take a deep breath so the doctor can check if the chest expansion is normal. The patient's range of motion will be examined, and the physician may press on the pelvis or move the legs into specific positions to check for pain. MRI scans can detect signs of this condition at earlier stages than other types of imaging studies, and x-rays may be performed as well. Treatment options usually center around medication. Doctors may prescribe non-steroidal anti-inflammatories like naproxen and indomethacin, and patients might be prescribed an interleukin-17 inhibitor or a TNF blocker. Physical therapy may help patients with maintaining posture and flexibility in the joints.

Osteomyelitis

Osteomyelitis is a serious bone infection triggered by bacteria or fungi. It is more common in men, and it may be life-threatening. In some cases, patients with this condition might not display any symptoms. The symptoms that do occur are often similar to other conditions that are not as serious, making osteomyelitis difficult to diagnose. Patients may notice pain in the infected portion of the bone, and this often worsens with movement. The infected area could appear red or swollen, and it might be warmer than the surrounding tissue.

Chills and a high fever could develop too. Infection with the Staphylococcus bacteria is the most frequent cause of osteomyelitis, and bacteria may enter the bloodstream through severe bone fractures, open wounds, or operations on the bones such as bone implants. Blood tests, imaging studies, and a biopsy may be necessary to diagnose this condition. Treatment may include antibiotics or antifungals, and patients might need to have surgical procedures to remove the infected bone. Amputation may be used as a last resort to stop the infection from spreading.