How to treat heel pain with a snapping sound?

At a Glance:

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Do you suffer from heel pain?

Cracking and popping noises in the feet may get bothersome. Should you be worried? Joints tend to make “popping” sounds either due to escaping gases, movement or tightening of ligaments, or roughness of the joint surfaces. You must talk to your doctor if there is any pain (and swelling) or weakening grip.

If these sounds are accompanied by pain, it is a cause for concern. Achilles tendon, which presents with pain along with a “snapping” sound, signals a ruptured tendon and requires treatment. Essentially, it is important to care for the heel since seemingly harmless pain can worsen. The person may even need to consult a doctor.

We will discuss more regarding when to seek a professional’s help in a later section.

What are the causes of heel pain?

Heel pain causes can be a variety of conditions. They may be hard to identify since heel pain is not usually caused by an injury, such as a fall or a twist. It tends to occur due to repetitive stress and the pounding motion of the heel.

Some of the possible causes of heel pain may be:

• Plantar fasciitis: The plantar fascia is a tissue that runs in the feet from the heel to the toes. Its inflammation is known as plantar fasciitis and results in heel pain. You may feel pain under the foot.
• Heel bursitis: A bursa, or sac, lines several joints and improves its functionality by easing the movement for muscles and tendons. Its inflammation causes bursitis, which leads to pain in the underside or back of the heel.
• Heel bumps: Also known as pump bumps, it is the abnormal growth of bone at the back of the heel. It is common in women who have developed long-term bursitis through frequent use of heels.
• Achilles tendonitis: The inflammation of the Achilles tendon can be caused due to overuse or other conditions. The tendon stops functioning properly due to microscopic tears, which it is unable to heal fully. It may be accompanied by a “snapping” sound.
• Tarsal tunnel syndrome: A portion of the lateral plantar nerve can be compressed due to conditions like a sprain, fracture, or varicose nerve, resulting in a trapped nerve. Its pinching may cause pain, numbness, or tingling in the heel.
• Stress fractures: Repeated stress on the heel due to strenuous activity or exercise, especially in athletes, leads to a break in the bone. This can be extremely painful and occur with a swelling. Continuous activity will aggravate the pain.

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What are the symptoms of heel pain?

Heel pain can be caused due to a wide range of conditions, of which those listed above are some. Some general signs to look out for if you suspect heel pain are:

• Plantar fascia results in a swelling on the underside of your heel. It may be a result of wearing poorly constructed or flat shoes. People with flat feet are also more prone to developing inflammation in the region.
• In the case of an injury, the onset of pain can be sharp and be accompanied by swelling.
• The pain may be worse in the morning, then subside after rest. Any activity can worsen the pain such that it increases by the end of the day.

When should you consult the doctor?

Heel pain can range from mild to severe, and consulting the doctor will help to alleviate any doubts regarding its severity. Some definite signs that you require medical attention are:

• Inability to walk comfortably using the affected heel
• Discoloration or swelling of the heel
• Pain, numbness, or tingling in the heel with fever
• Persistent heel pain for a few days
• Heel pain after rest or while sleeping
• Difficulty bending the foot

What kind of doctor do you see for heel pain?

Your heel pain might be the cause of an isolated event specific to the foot. In this case,  podiatrists or orthopedists are equipped to treat the condition. They can evaluate the underlying cause of the pain based on the recurring symptoms and suggest the appropriate mode of treatment. Surgery might be required if a condition like plantar fascia is not responsive to conventional non-surgical treatment like stretches, icing, rest, etc.

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How to diagnose heel pain?

An accurate diagnosis helps the podiatrist or orthopedist to clearly identify the cause of your pain and treat it effectively. A precise diagnosis may involve:

• Physical examination: You may be asked to walk around or move your feet and ankle for the orthopedist to evaluate the causes of pain. They may also inspect your foot for any discoloration, tenderness, or swelling.
• Imaging tests: An x-ray, or less frequently an MRI scan, will provide the orthopedist with a clear picture of conditions like bone spurs, stress fractures, or pump bumps.
• Blood tests: This is fairly uncommon, and the orthopedist may ask for specific blood tests if they suspect a bone infection or an inflammatory disease (like reactive arthritis) to be the underlying cause of your pain.
• Neurological exam: As discussed before, pain or numbness in the heel may be caused due to irritation or trapping of a nerve in the heel (eg. tarsal tunnel syndrome) or other parts. Its confirmation may also require an MRI or nerve conduction studies.

How to treat heel pain?

Do not begin treatment at home without confirming the cause for your heel pain. This might aggravate the pain. In case you are unsure of the root cause of your condition or how severe your case may be, it is best to seek medical advice.

The following therapy options are often recommended:

Physical therapy:

Regular exercises and stretches that stretch out your plantar fascia or Achilles tendon help to strengthen your muscles and increase the stability of the heel.

Medications:

In the case of plantar fasciitis, Achilles tendonitis, or heel bursitis, non-steroidal anti-inflammatory drugs may be prescribed to reduce pain and swelling. Steroid injections can be used as an alternative if the former is not effective.

Foot support:

Depending on your case, modifying your footwear or providing it extra support may help with relieving the pain. This can be done by:

• Switching to comfortable footwear with heel support or using heel cups or gel pad inserts.
• Using orthotics, which are medical devices that support your arch and correct any biomechanical issues.
• Wearing splints at night to keep the foot straight and allow the plantar fascia and Achilles tendon to stretch.
• Athletic taping under the foot for conditions like plantar fasciitis.

Surgery:

Surgery is not usually the first route for heel pain treatment unless in severe cases like the rupture of the Achilles tendon. Even in the case of plantar fasciitis, surgery becomes an option only if other treatment options fail to work for a year or longer.

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Do you need heel pain surgery?

Your heel pain may be caused due to a variety of reasons. We will be discussing two reasons that may warrant surgery. These could be:

• Plantar fasciitis: Persistent plantar fasciitis that does not improve even after 6-12 months of treatment may require surgery. Please note that only 5 out of every 100 patients fall under this category.
• Achilles tendonitis: Achilles tendon surgery is advised by many orthopedists if you have a ruptured tendon. They may still recommend alternative physical therapy or medications as the initial mode of treatment.

What are home remedies for heel pain?

If you feel your pain is not severe and can be treated at home, then you may try these options:

• Rest: Avoid putting stress on your heels. You can do this by lying down, avoiding walking or standing for too long, or keeping away from hard walking surfaces.
• Icing: Apply an ice pack to the affected area around 2-3 times a day for 15 minutes each. Ensure that the ice does not directly touch the skin.
• Night splints: People find quick relief in wearing splints at night. This helps to stretch the plantar fascia and relieve pain.
• Foot support: Change your footwear for a more comfortable pair or one that supports your foot. You may also opt for shoe inserts that provide extra support.

How to relieve heel pain with exercises?

Exercises that stretch out the calf are often helpful for patients with heel pain. If you feel comfortable and are assured that your condition is mild, you can exercise at home to help relieve your pain.

Wall calf stretch:

Stand while facing a wall. Place the foot with heel pain a few inches behind the other. Keep the back leg straight, with the foot touching the ground, while bending the knee of the front leg. Then, pull your hips into the wall until you feel a stretch in the calf of the back leg (the leg with heel pain). Hold this position for 10-15 seconds and repeat 4-5 times. 

Calf stretch on a step:

Stand on a step, ensuring that the heel of the foot with pain is hanging partially from the step i.e., stand on the ball of that foot. Try to lower your heel as far down it will go and hold for around 15 seconds. Repeat the stretch 2-4 times.

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How to prevent heel pain?

Preventing heel pain symptoms is essential for long-term care. General tips for the prevention of heel pain include:

• Reducing activity: Your heel needs time to rest and recuperate. Avoiding high levels of athletic activity or laborious tasks will help it to heal better.
• Maintaining a healthy body weight: Reduce the stress placed on your heel by adopting a healthy lifestyle that allows you to maintain body weight appropriate for your body.
• Wearing the right footwear: Choose comfortable footwear that provides support. Use shoe inserts to increase support.
• Warming up: Ensure that you warm up your muscles before indulging in any exercise or sport as your heels may get stressed otherwise.
• Early identification: Stay aware in case of any discomfort in your heel and adapt your activities accordingly. Early identification may help you prevent it from becoming severe.

Conclusion:

Cracking or snapping sound in the heel can be a cause for concern. It may be due to a simple or serious injury depending on the cause. To treat it effectively, the orthopedist or podiatrist should figure out the underlying cause. Generally, heel pain can be treated with physical therapy, medication, splints, footwear modifications, etc. In severe cases of plantar fasciitis or Achilles tendonitis, surgery may be recommended. In the case of persistent heel pain, consult an orthopedist at Yashoda Hospitals and follow a plan that can help your heel recover completely!

Read more about Heel Pain symptoms, causes and treatment

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References:

• https://www.medicalnewstoday.com/articles/181453.php
• https://www.verywellhealth.com/heel-pain-information-and-causes-2549378
• https://www.healthline.com/health/heel-pain
• https://www.webmd.com/pain-management/heel-spurs-pain-causes-symptoms-treatments#1
• https://www.healthline.com/health/sports-injuries/heel-spur-exercises#other-treatments
• https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/achilles-tendon-repair-surgery

About Author –

Dr. Shashi Kanth G, Sr. Consultant Orthopedic Surgeon, Yashoda Hospitals, Hyderabad
He is specialized in arthroscopy, sports medicine, and orthopedics. His expertise includes Lower Limb Joint Replacement Surgery, Lower Limb Arthroscopy, Sports Injuries, Foot and Ankle Surgery, & Management of Complex Trauma.