Ankylosing Spondylitis and Heel Pain - Verywell Health
The chronic autoimmune condition ankylosing spondylitis (AS) typically impacts the joints and soft tissue structures in the spine. But more advanced cases of AS can also affect peripheral areas like the heel and cause pain in this region. AS can lead to severe pain, stiffness, and ultimately immobility, especially if untreated.
This article will detail how ankylosing spondylitis causes heel pain and how this less-typical symptom is commonly managed.
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What Is Heel Pain?
Pain in the heel can be intermittent or more chronic and constant, depending on the person. It typically arises on the bottom or back portion of the calcaneus (heel) bone, though the sides of the foot may also be affected.
The pain quality can also vary, from dull and achy to sharper and stabbing. Occasionally, other symptoms like warmth, redness, or swelling may also be present in the heel and the surrounding areas.
Heel pain is commonly worse first thing in the morning or after long periods of sitting. Movement or gentle exercise may help alleviate this pain, though spending extended time on your feet tends to worsen it. In severe cases, heel pain can make it difficult to go on long walks and even cause you to limp.
When to Seek Help
If you are experiencing severe or progressive heel pain, be sure to see a healthcare provider. This is especially true if it is accompanied by other symptoms like back pain or stiffness, difficulty taking a deep breath, vision changes, or stomach pain.
Is Heel Pain a Symptom of Ankylosing Spondylitis?
While ankylosing spondylitis is commonly considered a spinal condition, it can affect many other structures, including the heel. This is because the disease is rheumatic in nature and causes widespread inflammation and pain throughout the body's joints. Occasionally, this includes peripheral regions like the heels, hips, shoulders, fingers, and toes.
Heel pain caused by ankylosing spondylitis typically arises when systemic inflammation targets the heel or the ligaments and tendons that support it. Most commonly, pain in this area occurs with more traditional AS symptoms like chronic back pain and spinal rigidity.
The exact reason that AS develops in some individuals is unknown. However, certain genetic markers predisposing people to get the disease have been identified. In addition, several groups of people seem to be at higher risk, including:
Treatments and Management of Heel Pain
To treat heel pain caused by ankylosing spondylitis, one of the first steps is getting control of the underlying inflammation associated with this condition. Several classes of medications are commonly utilized. These include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, such as Advil or Motrin (ibuprofen) and Aleve (naproxen), help alleviate the joint pain, stiffness, and swelling associated with AS.
- Azulfidine (sulfasalazine): This drug addresses joint swelling, severe pain, and gastrointestinal (GI) issues in severe cases.
- Tumor necrosis factor (TNF) blockers: These drugs, which include Enbrel (etanercept) and Humira (adalimumab), control symptoms in your spine and peripheral joints while also reducing inflammation in the stomach and eyes.
- Interleukin-17A (IL-17) inhibitors: These drugs, which include Cosentyx (secukinumab) and Taltz (ixekizumab), block molecules called cytokines from triggering inflammatory responses in the body.
In addition to medications, several other symptom-management strategies are also frequently suggested. Physical therapy can help improve your mobility and increase the strength in the muscles that support your foot and ankle. Regular aerobic exercise also plays an important role in alleviating your pain and stiffness.
Some healthcare providers also recommend changing your diet to reduce the intake of inflammation-causing foods. The research supporting this management strategy is still mixed, and more studies are needed.
In cases of severe joint damage from ankylosing spondylitis, surgery may be necessary to provide additional support or stability to the affected area.
When to See a Healthcare Provider
While heel pain can be caused by ankylosing spondylitis, the complaint is rarely seen in isolation if you have this disease. Instead, several other symptoms are also usually present at the same time. Among the most common ones are:
- Stiffness and pain in the low back
- Hip, shoulder, knee, or foot pain and stiffness
- Difficulty taking a deep breath due to rib soreness or stiffness
- Eye pain or vision changes
- Fatigue
- Weight loss or appetite changes
- Stomach pain or diarrhea
- Skin rashes
If you are experiencing heel pain or any of the other symptoms listed above, it is important to contact a healthcare provider. This is especially true if the symptoms are getting progressively worse or are severe. Discussing your symptoms with an experienced professional can help identify the appropriate treatments that are available.
Summary
Ankylosing spondylitis is a chronic autoimmune condition that causes elevated levels of inflammation in the body. While the most commonly affected areas are the spine and pelvis, occasionally peripheral joints such as the heel can be impacted. When this occurs, one potential symptom is heel pain.
Many treatments can manage this disease including medications, physical therapy, dietary changes, and regular exercise. Be sure to speak to a healthcare provider about any symptoms you are experiencing so they can diagnose the cause and determine which interventions are appropriate.
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