Heel pain is a widespread concern, affecting millions globally. It can range from a mild annoyance to a debilitating issue, disrupting daily activities. While the source of the pain can vary, understanding the most common causes empowers you to identify potential culprits and seek appropriate treatment. This blog explores the five most frequent causes of heel pain, equipping you with the knowledge to navigate your path to pain-free feet.

1. Plantar Fasciitis
Plantar fasciitis is widely recognised as a leading cause of heel pain. It involves inflammation of the plantar fascia, a thick band of fibrous tissue that runs along the bottom of your foot, connecting your heel bone to your toes. The plantar fascia acts as a shock absorber and supports the arch of your foot.
Symptoms:
- Sharp, stabbing pain in the heel, especially in the morning upon taking the first steps.
- Pain that worsens with prolonged standing or activity.
- The pain might lessen somewhat after a few minutes of walking but can return with continued activity.
Risk Factors:
- Age: Plantar fasciitis is more common in people between the ages of 40 and 60.
- Foot Mechanics: Flat feet, high arches, or abnormal walking patterns can contribute to plantar fasciitis.
- Obesity: Excess weight puts additional strain on the plantar fascia.
- Certain Activities: Activities that place a lot of stress on the heel, like running or jumping, can increase the risk.
- Tight Calf Muscles: Tight calf muscles can pull on the plantar fascia, contributing to inflammation.
Treatment:
- Rest: Reducing activities that aggravate the pain is crucial for promoting healing.
- Ice Therapy: Applying ice packs to the affected area for 15-20 minutes at a time, several times a day, can help reduce inflammation.
- Stretching: Regularly stretching your calf muscles and plantar fascia can improve flexibility and reduce tension.
- Supportive Footwear: Wearing shoes with good arch support and cushioning can alleviate pressure and promote healing. Orthotics might be recommended for additional support.
- Over-the-counter pain relievers: Medications like ibuprofen or acetaminophen can offer temporary pain relief.
- Physical therapy: Strengthening exercises and stretches prescribed by a physical therapist can improve flexibility, stability, and reduce the risk of future problems.
2. Plantar Fasciosis
Plantar fasciosis is sometimes confused with plantar fasciitis, but they have distinct characteristics. While plantar fasciitis involves inflammation, plantar fasciosis is a degenerative condition where the plantar fascia weakens and tears over time.
Symptoms:
- Aching pain in the heel, often described as dull or achy, rather than sharp.
- The pain might be present throughout the day, not just in the mornings.
- Pain might worsen with activity but doesn’t necessarily improve significantly with rest.
Risk Factors:
Similar to plantar fasciitis, these factors can contribute to plantar fasciosis:
- Age
- Foot Mechanics
- Obesity
- Certain Activities
- Tight Calf Muscles
However, plantar fasciosis is more likely to occur in older individuals who have had plantar fasciitis for a long time.
Treatment:
Treatment strategies for plantar fasciosis often overlap with those for plantar fasciitis. However, addressing the underlying degenerative changes might require additional measures like:
- Night Splints: Splints worn during sleep can help stretch the plantar fascia and alleviate morning pain.
- Extracorporeal shockwave therapy (ESWT): This non-invasive therapy uses sound waves to stimulate tissue healing and is sometimes used for chronic plantar fasciosis.
- Orthotics: Custom orthotics can provide more targeted support and assist in managing the degenerative changes in the plantar fascia.
3. Heel Spur
A heel spur is a calcium deposit that forms on the underside of the heel bone. While not everyone with a heel spur experiences pain, it can irritate surrounding tissues and lead to discomfort.
Symptoms:
- Pain located directly under the heel bone, often described as sharp or stabbing.
- Pain might worsen with weight-bearing activities and improve with rest.
Risk Factors:
- Plantar Fasciitis: Chronic plantar fasciitis can sometimes lead to the formation of a heel spur.
- Tight Calf Muscles: Tight calf muscles can pull on the plantar fascia, contributing to inflammation and potentially spur formation.
- Obesity: Excess weight puts additional strain on the plantar fascia and heel bone, increasing the risk of a heel spur.
- Repetitive Stress: Activities that repeatedly stress the heel, like running on hard surfaces or wearing shoes with poor cushioning, can contribute to heel spur development.
Treatment:
- Similar to plantar fasciitis, treatment often focuses on reducing inflammation and pain. This might involve:
- Rest
- Ice therapy
- Stretching
- Supportive footwear
- Over-the-counter pain relievers
- Corticosteroid injections: Injections can be used to reduce inflammation in severe cases.
- Shoe inserts with heel pads: These can help distribute pressure more evenly and alleviate pain.
- Surgery: In rare cases, surgery might be necessary to remove the heel spur, but this is usually a last resort.
4. Achilles Tendinitis
The Achilles tendon is a large tendon that connects your calf muscles to your heel bone. Achilles tendinitis involves inflammation of this tendon, causing pain and stiffness.
Symptoms:
- Pain at the back of the heel, especially during activity or when pushing off with your toes.
- Stiffness in the Achilles tendon, particularly in the morning.
- Swelling and tenderness in the area around the tendon.
Risk Factors:
- Overuse: Activities that involve repetitive jumping or running can overuse the Achilles tendon, leading to inflammation.
- Tight calf muscles: Tight calf muscles can put additional strain on the Achilles tendon.
- Sudden increase in activity: Suddenly increasing the intensity or duration of activities that stress the Achilles tendon can increase the risk.
- Improper footwear: Shoes with poor cushioning or lack of support can contribute to Achilles tendinitis.
Treatment:
- Rest: Reducing activities that aggravate the pain is crucial for promoting healing.
- Ice therapy: Applying ice packs to the affected area for 15-20 minutes at a time, several times a day, can help reduce inflammation.
- Stretching: Regularly stretching your calf muscles can improve flexibility and reduce tension on the Achilles tendon.
- Supportive footwear: Wearing shoes with good cushioning and heel support is essential.
- Physical therapy: Strengthening exercises and stretches prescribed by a physical therapist can improve flexibility and stability in the ankle and calf.
- Immobilisation: A walking boot or splint might be recommended for short periods, particularly for severe inflammation, to restrict movement and promote healing.
5. Bursitis
Bursae are fluid-filled sacs that cushion bones, tendons, and muscles near joints. Retrocalcaneal bursitis is inflammation of the bursa located behind the heel bone. This inflammation can cause pain and tenderness in the heel.
Symptoms:
- Pain located directly behind the heel bone, often described as a dull ache or burning sensation.
- Pain might worsen with activity and improve with rest.
- Tenderness and swelling in the area behind the heel bone.
Risk Factors:
- Activities that put pressure on the heel: Activities like running, jumping, or wearing tight shoes can irritate the bursa.
- Tight calf muscles: Tight calf muscles can put additional strain on the bursa.
- Obesity: Excess weight increases stress on the heel and bursa.
- Improper footwear: Shoes with poor cushioning or lack of support can contribute to bursitis.
Treatment:
- Similar to Achilles tendinitis, treatment often focuses on reducing inflammation and pain. Strategies might include:
- Rest
- Ice therapy
- Stretching
- Supportive footwear
- Over-the-counter pain relievers
- Corticosteroid injections: Injections can be used to reduce inflammation in severe cases.
- Shoe inserts with heel pads: These can help distribute pressure more evenly and alleviate pain.
Taking Control of Your Heel Pain
Understanding the most common causes of heel pain empowers you to identify potential culprits and seek appropriate treatment. Remember, early diagnosis and intervention are crucial for optimal healing and preventing complications. Don’t hesitate to consult a healthcare professional if your heel pain persists despite self-care measures. They can provide a diagnosis, recommend personalised treatment options, and get you back on your feet, pain-free.