Foot surgery / sports medicine - heel pain - feels like a strained or cramping muscle i feel a tightness or cramping pain in one heel. not sure when it started but it has been bothering me for more than a month. it may have started after i began yoga. n

Many : Many problems can cause heel pain and should be evaluated by a physician. The most common cause of heel pain is plantar fasciitis (pf). In early stages, patients with pf typically have pain with the first step in the am just getting out of bed. With warm up and stretching it can subside during the mid day. I reccomend an evaluation with xray to exclude a fracture or bony tumor (rare). Heel "spurs" are common and usually not the cause of pain if it is pf, then try conservative treatment- shoe change, decrease impact activity, stretching of the calf muscle and the arch of the foot, nsaids, and ice. Tougher cases can be helped by night splints. Injections and surgery should be avoided as a first line treatment. If symtpoms worsen and last longer than 6 months extracorporreal shock wave therapy has been shown to be beneficial.- good luck.

Ice and massage: If its just a strain ice, massage, and support helps a lot, if pain continues see specialist for further treatment.

A heel spur is : Probably what is bothering you. All a heel spur is is the pull of the plantar fascia (arch fascia) on the heel. It gets tight and inflamed an pulls on the heel. It hurts 1st thing in the am and walking in hard sole shoes or barefoot. Treat with plantar massage, stretching, ice and tennis shoe wear from wakeup to bed.

Many possibilities: Your pain could be as a result of many different things. Causes of pain may include: trauma (fracture, sprain, arthritis), infection, metabolic conditions (gout), musculoskeletal or biomechanical abnormality and neurologic conditions (neuropathy). A thorough history and physical exam and possibly some laboratory and radiology exams are needed to determine the exact cause.

Heel pain: As previously mentioned heel pain can occur for a number of reasons and should be evaluated by a physician to determine the root. However, in most of my patients pain on the bottom is from plantar fasciitis (www.Drmarkgalland.Com 1/16/13), while pain on the back is achilles tendonitis or bursitis. Start with rice and if symptoms subside gradually return to activity, but it symptoms persist see doc.