Heel Pain: Causes & Treatment

Written By: Dr. Mohamed Ghanem

Updated On:January 29, 2025

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What is Heel Pain?

The heel is the largest bone in your foot. Heel discomfort may occur if you misuse or harm your heel. This can be minor or incapacitating. If easy home cures don't relieve the pain, you might need to have a doctor or podiatrist diagnose the problem.

Causes of Heel Pain

The plantar fascia, a band of tissue in the foot, is what causes the majority of cases of heel pain when it sustains injury and thickens. The thickening of the plantar fascia is referred to medically as plantar fasciitis.

Obesity, improper shoe fit, running and leaping on hard surfaces, an unusual walking gait, traumas, and certain diseases are all common causes of heel pain, as well.

Causes of Pain Behind the Heel

Back heel pain can be brought on by a number of concerns, including the following:

  • Achilles tendon: The fibrous tissue that joins the calf muscle to the heel bone is known as the Achilles tendon, which can become inflamed. The tendon becomes injured by overuse. Upon injury, the back of the heel becomes painful, swollen, and stiff.
  • Bursitis: Bursitis happens when the bursae, which are fluid-filled sacs, swell. These sacs provide joint protection and permit easy movement. The back of your heel could feel sore and bruise-like. Bursitis often develops as a result of prolonged standing.
  • Haglund's deformity: An enlarged bony hump may develop in the heel's back as a result of ongoing inflammation and irritation. Higher-heeled footwear may exacerbate the pain and bump.
  • Sever’s Disease: In active children between the ages of 8 and 14, Sever's disease (calcaneal apophysitis) is a common source of heel pain. Children who engage in sports that include a lot of running and jumping are more likely to experience this issue. The growth plate in the heel's rear becomes irritated due to increased sports activity.

Causes of Pain Beneath the Heel

The following conditions can result in pain beneath the heel:

  • Stepping on a hard, pointy object can cause the fat cushioning under the heel to bruise. Even if there is no visible discoloration, walking will cause your heel to feel sore. Both a stress fracture and Sever's disease can result in discomfort that runs along the bottom, side, and back of the heel.
  • The most common cause of heel discomfort is by far plantar fasciitis. It happens when the connective tissue called fascia, which runs down the bottom of the foot, stretches or tears. This painful ailment is more likely to occur in those who frequently run and jump. Common irritants include treadmills and hard surfaces used for work or exercise.
  • Long-term plantar fasciitis can result in the formation of a bony growth on the heel bone known as a heel spur. Although some people experience pain, heel spurs are typically not uncomfortable.

Symptoms of Heel Pain

Depending on the reason, heel pain can have various symptoms. Together with pain, you could also feel:

  • Bony growth on the heel
  • Discoloration
  • Stiffness
  • Swelling
  • Tenderness
  • Pain after getting up from a lying-down or seated position

When to see a doctor for Heel Pain?

If you experience heel pain, you can start by using some natural treatments, including rest, to reduce your symptoms. Make an appointment with your doctor if your heel pain doesn't go away in two to three weeks.

Immediately contact your physician if you have any of the following symptoms in your heel:

  • Severe pain
  • Abrupt
  • Redness
  • Edema
  • Inability to walk

Heel Pain Risk Factors

The following factors can increase your risk of developing heel pain:

  • Being obese, overweight, or pregnant
  • playing sports involving running or jumping, such as basketball, soccer, or ballet
  • Having low or high arches in the feet
  • Wearing high heels or footwear with insufficient arch and heel support
  • Having stiff Achilles tendons or calf muscles
  • Unusual gait patterns, such as hyperpronation (ankle turns inward)
  • All day standing or walking, particularly on rough terrain

Heel Pain Complications

Your everyday activities may be impacted by crippling heel discomfort. Also, it might alter how you walk. If this occurs, you can be more likely to get unsteady and fall, increasing your risk of suffering additional injuries.

Heel Pain Diagnosis

Your medical professional will evaluate your symptoms and do a physical examination. X-rays may also be taken to look for joint injury, bone fractures, arthritis, and bone alignment. Rarely, you could require an ultrasound or MRI. These may disclose soft tissue issues that X-rays are unable to show.

Heel Pain Treatment

The majority of heel pain issues resolve over time with nonsurgical therapies. Treatments concentrate on reducing stress and strain on the heel, reducing tension and inflammation, and improving foot flexibility. These remedies consist of:

  • Steroid injections can reduce swelling and pain. Steroid injections for tendon issues should be administered sparingly, if ever; nonetheless, they may be beneficial for bursitis and plantar fasciitis.
  • Shoe inserts (orthotics) that are purchased over the counter or created to order help relieve pressure on the heel. Using a splint at night can provide comfort for some people, especially if they have morning pain. For symptoms that are more severe, a walking boot may be required. For everyday wear and exercise, you might also need to switch to more supportive footwear.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) and cold packs are effective painkillers that reduce swelling.
  • Soft tissue adhesions can be released with massage, physical therapy, and ultrasound treatment. These remedies could lessen discomfort and inflammation.
  • For stiff tendons and muscles, your doctor can demonstrate heel stretches for you.
  • To support the foot arch or heel, use athletic or medical tape.

Heel Pain Prevention

Although while it might not be able to stop every occurrence of heel pain, there are some simple precautions you can take to protect your heel and stop the pain:

  • Put on shoes that are supportive of the foot and fit properly.
  • Use the appropriate footwear for exercising.
  • To prepare for exercise, stretch your muscles.
  • With physical exertion, pace yourself.
  • Keep up a balanced diet.
  • When you're worn out or your muscles start to hurt, make sure to rest.
  • Keep a healthy weight.

References

Agyekum, E. K., & Ma, K. (2015). Heel pain: A systematic review. Chinese Journal of Traumatology18(03), 164-169.

Aldridge, T. (2004). Diagnosing heel pain in adults. American family physician70(2), 332-338.

Barrett, S. L., & O'Malley, R. (1999). Plantar fasciitis and other causes of heel pain. American family physician59(8), 2200.

Thomas, J. L., Christensen, J. C., Kravitz, S. R., Mendicino, R. W., Schuberth, J. M., Vanore, J. V., ... & Baker, J. (2010). The diagnosis and treatment of heel pain: a clinical practice guideline–revision 2010. The Journal of Foot and Ankle Surgery49(3), S1-S19.

Tu, P., & Bytomski, J. R. (2011). Diagnosis of heel pain. American family physician84(8), 909-916.

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