Heel Pain: Identifying the Cause and Finding Relief
Heel pain is one of the most common foot complaints, but it is not a single condition. Pinpointing exactly where and when it hurts is the key to choosing the right treatment.
Where does it hurt?
Location is the most useful clue. Pain under the heel usually points to plantar fasciitis or a fat-pad problem. Pain at the back of the heel suggests the Achilles tendon or bursitis. Pain across the whole heel, especially after a fall or sudden onset, can indicate a stress fracture and needs assessment.
Common causes of heel pain
- Plantar fasciitis — sharp under-heel pain, worst in the morning
- Achilles tendinopathy — back-of-heel pain and stiffness
- Retrocalcaneal bursitis — swelling at the back of the heel
- Heel fat-pad atrophy — deep, bruise-like central heel pain
- Stress fracture — worsening pain with activity
- Sever's disease — heel pain in active children and teens
General treatment principles
Most non-fracture heel pain responds to the same core strategy: reduce aggravating load, stretch the calf and fascia, ice after activity, and wear cushioned, supportive footwear. Heel cups and orthotics help offload sore tissue. Persistent or severe pain should be evaluated to rule out fracture or nerve involvement.
When to see a professional
Seek care if pain is severe, follows an injury, does not improve after a few weeks of self-care, or comes with numbness, tingling, swelling, redness or fever. People with diabetes should have any new foot pain assessed promptly.
Frequently asked questions
- Is heel pain always plantar fasciitis?
- No. Achilles problems, bursitis, fat-pad atrophy and stress fractures all cause heel pain in different locations.
- When should I worry about heel pain?
- If it is severe, follows an injury, or is paired with numbness, swelling or fever, get it checked.
Sources & further reading
- Heel pain causes, Mayo Clinic
- Heel pain, NHS
- Plantar heel pain, American Podiatric Medical Association (APMA)