Nerve Pain in Back of Heel: Symptoms, Causes & Treatments

Introduction

Nerve pain in the back of the heel is a unique type of discomfort that can make even the simplest tasks challenging. 

Known for its sharp, electric-like pain, nerve pain in the heel can range from mild to intense. This type of pain often affects walking, standing, and other daily activities, resulting in altered gait or limping. 

Understanding the causes and symptoms can lead to more effective treatment options.

In this article, we’ll cover the anatomy, common causes, and management strategies for nerve pain in the heel. 

We’ll also discuss how chiropractic care can offer lasting relief by addressing underlying issues, including misalignments and nerve entrapments, helping you achieve optimal heel health.

Nerves and Nerve Pathways Involved in Heel Pain

Understanding the nerve pathways linked to heel pain is essential, as different nerves can cause distinct types of discomfort based on their role and location. 

Here’s a closer look at the primary nerves involved in heel pain:

Tibial Nerve

The tibial nerve is a major nerve that runs down the back of the leg and supplies sensation to the heel and sole. It travels through the tarsal tunnel, a narrow passage inside the ankle. 

When compressed or irritated within this tunnel—known as tarsal tunnel syndrome—the tibial nerve can cause sharp, burning, or tingling pain in the heel. 

Lateral Plantar Nerve

The lateral plantar nerve branches off from the tibial nerve and provides sensation to the outer part of the heel. 

It can become trapped or compressed near the heel bone, leading to a specific type of heel pain known as Baxter’s neuropathy. 

Medial Plantar Nerve

Responsible for supplying the inner part of the heel and sole, the medial plantar nerve can also be a source of heel pain if compressed. 

This nerve branch, also stemming from the tibial nerve, is particularly susceptible to entrapment in individuals with flat feet or overpronation.

Lumbar and Sacral Spinal Nerve Roots (L4-S3)

The lumbar and sacral nerve roots (L4-S3) in the lower back give rise to nerves that travel down the leg and eventually supply the foot and heel. 

Compression or irritation of these nerve roots, often due to conditions like a herniated disc or spinal stenosis, can lead to radiating pain in the heel and foot, a phenomenon known as lumbar radiculopathy. 

Sciatic Nerve

The sciatic nerve, formed by the lumbar and sacral roots, is the longest and largest nerve in the body, running from the lower back down to the foot. 

Compression or damage to the sciatic nerve, particularly in conditions like sciatica, can cause radiating pain along its path, including in the heel. 

By understanding these nerve pathways and how they contribute to heel pain, patients and providers can work together to accurately diagnose and treat the root cause of discomfort. 

Chiropractic care can play a key role in relieving this pain by addressing spinal misalignments and promoting optimal nerve health, ultimately reducing heel pain related to nerve entrapment or compression.

Symptoms of Nerve Pain

Nerve pain in the heel often comes with distinct symptoms that differentiate it from other types of heel pain. These may include:

• Burning or Shooting Pain: Sharp, shooting pain that can extend into the foot.
• Numbness or Tingling: A common sensation indicating nerve involvement.
• Hypersensitivity: Increased sensitivity to touch or pressure in the affected area.
• Weakness in Foot Muscles: Difficulty with certain foot movements.
• Swelling, Warmth, or Redness: These symptoms can accompany inflammation or nerve irritation.
• Changes in Skin Texture or Appearance: The skin may become shiny or appear different due to nerve issues.
• Pain Worse at Night or After Rest: Nerve pain often intensifies during rest or after periods of inactivity.

Common Causes of Nerve Pain in the Back of Heel

Several underlying conditions can cause nerve pain in the heel, including:

1. Tarsal Tunnel Syndrome: 

Similar to carpal tunnel in the wrist, tarsal tunnel syndrome compresses the tibial nerve, leading to heel pain. Symptoms may radiate into the arch or toes and worsen with prolonged standing or walking. 

This type of nerve compression is often accompanied by numbness or weakness in the foot, making daily activities challenging.

2. Baxter’s Nerve Entrapment: 

Often called a “trapped nerve in heel”, it is caused by compression of the lateral plantar nerve. 

This condition is common among runners or individuals who place repeated stress on the heel, resulting in aching or stabbing pain along the side of the heel. 

Baxter’s nerve entrapment or Baxter’s neuropathy is often misdiagnosed as plantar fasciitis due to similar symptoms, but it specifically involves nerve compression.

3. Plantar Fasciitis with Nerve Involvement: 

While commonly a ligament issue, plantar fasciitis can sometimes irritate nearby nerves.

4. Lumbar Radiculopathy (Sciatica): 

Sciatic nerve issues or lumbar spine issues may radiate pain to the heel. 

This type of pain may be accompanied by symptoms like weakness, numbness, or a tingling sensation down the leg, especially during activities that put pressure on the lower back.

5. Peripheral Neuropathy: 

Often due to diabetes or systemic conditions, neuropathy can lead to nerve pain in the heel.

6. Achilles Tendonitis:

Inflammation in the Achilles tendon can sometimes affect nearby nerves, causing pain.

7. Haglund’s Deformity: 

A bony enlargement on the back of the heel that may compress nearby nerves, resulting in pain.

Self-Care Strategies to Ease Pain

If you’re experiencing nerve pain in the heel, there are several strategies you can try to find relief:

• Rest and Activity Modification: Avoid activities that worsen the pain to allow healing.
• Proper Footwear: Supportive shoes can reduce pressure on the heel and help prevent nerve irritation.
• Ice and Heat Therapy: Alternating between ice and heat can reduce inflammation and improve blood flow.
• Healthy Weight Maintenance: Excess weight puts additional strain on the heel and nerves.
• Stretching and Exercise: Gentle stretches for the calf and foot muscles can help relieve tension and promote healing.
• Over-the-Counter Pain Relief: Non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and reduce inflammation.

When to Seek Professional Help

Certain symptoms warrant a visit to a healthcare professional. Consider seeing a specialist if you experience:

• Persistent Pain: Pain lasting more than a few weeks despite self-care efforts.
• Severe Pain Affecting Daily Activities: Pain that limits your ability to perform normal activities.
• Signs of Infection or Systemic Illness: Fever, redness, or warmth at the site, as these may indicate infection.
• Numbness or Weakness in the Foot: This can be a sign of more serious nerve involvement.

Conclusion

Nerve pain in the back of the heel is often complex and requires a detailed understanding of the causes and symptoms for effective treatment. Chiropractic care can be an essential part of managing heel nerve pain. 

By addressing misalignments and improving joint mobility, chiropractic adjustments can relieve tension in the affected areas and enhance nerve function. 

If heel pain is holding you back, consider a visit to Crist Chiropractic for a personalized care plan tailored to your needs.

FAQs

1. What does a trapped nerve in the foot feel like?

A trapped nerve can feel like sharp, shooting pain, numbness, or tingling in the affected area.

2. Can nerve damage in the heel be repaired?

Yes, with proper treatment, including chiropractic care and physical therapy, nerve damage can often improve over time.

3. Why does the back of my heel hurt when I walk?

This may be due to nerve entrapment (nerve trapped in the heel) or other underlying conditions like Achilles tendonitis or tarsal tunnel syndrome.

4. What are effective treatment options for nerve pain in the back of the heel?

Treatment options include self-care, physical therapy, and chiropractic care, which can reduce nerve compression, improve mobility, and support healing.