Posterior heel pain

Heel pain is widely perceived to be a minor ailment that usually runs a self limiting course. This is not always the case however, and a proportion of the millions of people affected each year will suffer chronic symptoms. Heel pain can be broadly classified as posterior or plantar heel pain. Posterior heel pain may be from non-insertional or insertional Achilles tendon problems, or occasionally due to pathology of the surrounding structures. Most sufferers will improve with a combination of time and proper stretching regimens. A proportion of patients, however, have resistant symptoms which can be difficult to manage and require operative treatment. This article, focussing on posterior heel pain, offers a pragmatic approach to assessment and management.