Dr. Sandra Klein tearts patients at
Center for Advanced Medicine
Orthopedic Surgery Center
4921 Parkview Place, A, 6
St. Louis, MO 63110
Phone: 314-514-3500 Fax: 314-747-2599
Washington University Orthopedics
14532 S. Outer 40 Drive
Chesterfield, MO 63017
Question: I have pain on the back of my heel. Is this caused by plantar fasciitis or could it be something else?
Answer: Pain on the back of the heel is usually Achilles tendinitis, not plantar fasciitis. While symptoms may be very similar, they are two very different conditions. The Achilles tendon is the large tendon that attaches to your heel bone right where the back of your shoe hits your ankle. This motion provides the power in the push off phase of the gait cycle. Pain in this area is related to inflammation and overuse of the Achilles tendon.
Plantar fasciitis is typically on the bottom of the heel. Pain and inflammation of plantar fasciitis is also related to overuse.
Achilles tendonitis starts after a particular activity places too much stress on the tendon. This condition usually hurts when you first get out of bed in the morning and can also be worse after heavy activity. Swelling and worsening pain occurs if the condition goes untreated. Most people tend to delay seeking treatment assuming that it will get better on its own.
If you start having Achilles tendon pain it is best to immediately modify your activities to reduce pain. Since this is an overuse injury, the best immediate treatment is to rest your foot and ankle. Anti-inflammatory medication can be helpful for both swelling and pain. If the pain continues for over a week, it is advised to seek medical attention from an orthopedic specialist.
Healing of the Achilles tendon is often slow. Initial treatment involves both immobilization and activity modification. Physical therapy is also an important part of the recovery process. For severe cases that become worse despite appropriate treatment, surgery is a consideration.