Fibromyalgia heel pain is a symptom that may seem the most surprising to some readers, yet it affects countless individuals living with this complex condition.
Many people associate fibromyalgia with deep pain in the muscles and joints all over the body and an overwhelming fatigue – but the feet, the heels in particular, may be a surprisingly common source of daily pain.
Understanding Fibromyalgia Heel Pain Causes
Fibromyalgia is categorized as a centrally-sensitized pain syndrome, which is simply a fancy way of saying that the brain enhances pain signals well past what would be expected due to minor tissue injury or pathology.
Heels are not spared from this process.
Since the feet support body weight throughout the waking hours of each day, heel tissue is exposed to constant mechanical stress, so to the brain, even pressure typical of normal walking signals can register as the pain of a major injury.
Tender points, nerve hypersensitivity, and peripheral nerve sensitivity
In the past, doctors diagnosed fibromyalgia based on the presence of specific tender points – certain locations on the body that elicited pain pain response when pressed upon lightly.
While this strict criteria is no longer used extensively, nerve hypersensitivity continues to be a core feature of diagnosis.
There are many sensitive nerves within each heel, but in someone with central nervous system hyperactivity, those nerve signals are magnified and amplified.
This nerve hypersensitivity causes the internal heel sensations:
- Burning sensation, pins-and-needles type discomfort that worsens with weightbearing
- Deep, dull pain that persists during the day
- Brief, sharp pain for the first several steps when waking up in the morning
- Significant sensitivity to touch, even that from light socks or bedding
- the sensation of having too much input running through the heel
Finally, it is worth noting that fibromyalgia heel pain often overlaps with plantar fasciitis, which is characterized by inflammation of a band of ligament running down the bottom of the foot.
Many people come to diagnosis with plantar fasciitis, but once inflammation diminishes, if heel pain persists, this is often the indication that central nervous system sensitization has taken over as the primary cause.
It is helpful to distinguish between both diagnoses because treatment strategies are dissimilar.
Common Triggers That Worsen Fibromyalgia Heel Pain
There are many triggers which can cause your heel pain to worsen.
Most of the time, understanding these triggers enables people with fibromyalgia to have more control of their pain in daily life.
Four triggers in particular tend to exacerbate heel pain in people with fibromyalgia:
Physical activity and inactivity-specific activities
Both the extremes of activity-stationary and stationary-are challenging for heel pain patients.
Long-standing and lengthy walks cause excess mechanical stressors on already sensitive tissues.
However, even brief durations of sedentary behavior cause stiffness, which can make the first few steps once you finally get up from your desk or chair that much more painful.
If you can find a comfortable middle ground of short, multiple activity breaks, not too much activity and not too little, you will get the best results for most people.
Your common physical triggers include:
- Hard floors without ample padding or cushion
- Shoes that lack good arch support or bottoms that are thinning or slick
- Feet that are cold and chilly, which can increase nerve responsiveness
- New shoes, especially when you are not used to more supportive shoe gear
Sleep problems and pain cycles
Sleep deprivation may both trigger and intensify pain.
During good sleep patterns, the brain performs essential tissue repair processes and balances pain pathways.
When sleep is disrupted- which happens far too frequently in the myriad of people with fibromyalgia- pain thresholds are lowered, and patients often report more intense heel pain the following days.
Treating your sleep problems can do more than help you feel better rested, it can also go far toward decreasing heel pain episodes.
The most efficient treatment combines several treatments: mild supportive shoes, specific stretches, adequate sleep measures and proper medical assistance simultaneously. And don’t use blunt advice that homogenizes your heel pain. Insist on treatments that take into account the fact that fibromyalgia is systemic.
Communicate and collaborate with your doctor, consult a foot specialist along side your rheumatologist, and carefully note your triggers. The accumulative effect of small even tiny incrementations of healing does make a difference. You deserve something that actually alleviates that actual phenomenon that is occurring and not only a band aide.