If you have pain in your heel, your first reaction might be to think that you have a condition that typically affects this area of the body, such as plantar fasciitis. Another possibility is gout.
Although the pain of gout most commonly occurs in the big toe, it can also be located in other areas, including your heel.
Gout is a type of inflammatory arthritis caused by high levels of uric acid in your body. This excess uric acid can form a substance called urate crystals.
When these crystals affect a joint, such as the heel, it can result in sudden and severe symptoms, including:
Experiencing a sudden and intense pain in your heel generally warrants a trip to your doctor.
If your doctor suspects gout as the cause of the discomfort, they may run one or more tests to confirm or eliminate gout as the issue, such as the following:
To measure the levels of uric acid and creatinine in your blood, your doctor might recommend a blood test.
A blood test can return misleading results, as some people with gout don’t have unusual levels of uric acid. Others have high uric acid levels, but don’t experience gout symptoms.
You doctor might recommend an X-ray, not necessarily to confirm gout but to help rule out other causes of inflammation.
A musculoskeletal ultrasound can detect urate crystals and tophi (nodular crystalline uric acid). According to the Mayo Clinic, this test is used more extensively in Europe than in the United States.
Dual-energy CT scan
This imaging scan can detect urate crystals even when inflammation isn’t present. Because this test is expensive and not widely available, your doctor might not suggest it as a diagnostic tool.
There is no cure for gout, but treatment to limit attacks and control painful symptoms are available.
If your doctor diagnoses gout, they will most likely suggest medication and certain lifestyle changes based on findings in the testing and your current health.
Certain medications treat gout attacks or flare-ups. Others reduce the risk of potential gout complications.
Medications for gout attacks
To treat gout attacks and to prevent future ones, you doctor may recommend these medications:
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Initially, your doctor might suggest over-the-counter (OTC) NSAIDs, such as naproxen sodium (Aleve) or ibuprofen (Advil).
If these OTC medications aren’t enough, your doctor might prescribe more powerful NSAIDs such as celecoxib (Celebrex) or indomethacin (Indocin).
Colchicine (Mitigare, Colcrys) is a medication that your doctor may prescribe based on its proven effectiveness in reducing heel gout pain.
Side effects of taking colchicine, especially in large doses, can include diarrhea, nausea, and vomiting.
If NSAIDs or colchicine aren’t appropriate for you, your doctor might recommend corticosteroid medications, either in pill form or via injection, to control inflammation and pain.
An example of this type of medication is prednisone.
Medications to prevent gout complications
Your doctor might recommend medicine to limit gout-related complications, especially if any of the following apply to your situation:
- particularly painful gout flare-ups
- numerous gout attacks every year
- joint damage from gout
- chronic kidney disease
- kidney stones
These medications work in one of the following ways:
- Some block uric acid production. Examples include xanthine oxidase inhibitors (XOIs), such as febuxostat (Uloric) and allopurinol (Lopurin).
- Others improve uric acid removal. Uricosurics, including lesinurad (Zurampic) and probenecid (Probalan), work this way.
In addition to taking medication, your doctor may recommend lifestyle changes to help prevent gout flare-ups, including:
- avoiding certain foods that may trigger gout attacks
- cutting back on the amount of alcohol you drink
- maintaining a healthy weight
- staying hydrated
Although the heel isn’t the most common place to have gout, when gout affects your heel, every step can be painful.
There is no cure for gout, but medications are available that can help reduce painful symptoms and attacks.
If you have severe pain in your heel, see your doctor for a full diagnosis and recommendations for treatment.
Learn more about gout, including the different types, risk factors, and possible complications.