5 Common Causes of Heel Pain and How to Treat Them

heel pain
Kris Ubach and Quim Roser / Getty Images

Heel pain is an extremely common complaint, and there are several common causes. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the cause. If you have pain, some causes include:

Common Causes of Heel Pain

Plantar Fasciitis

Plantar fasciitis is the most common condition that causes heel pain. Plantar fasciitis is due to irritation and inflammation of the tight tissue that forms the arch of the foot.

Plantar fasciitis is characterized by pain on the bottom of the heel that is often felt upon weight bearing after rest, such as when taking your first steps in the morning or when standing up after prolonged sitting. There are many treatments that people use for plantar fasciitis including ice application, anti-inflammatory medications, footwear modification, stretching, and others. Often it takes time and avoidance on aggravating activities in order for the body to fully recover from this condition.

Achilles Tendonitis

Achilles tendonitis is inflammation due to overuse or trauma to the Achilles tendon, the large cord-like tendon that attaches to the back of the heel bone. The pain is usually located at the part of the tendon that is slightly above the heel bone, although this can also cause pain directly at the insertion of the tendon on the heel bone. Achilles tendonitis often causes nagging pain that may take months or longer to resolve.

Some simple treatments including ice, anti-inflammatory medications, or heel wedges can be helpful, but in more advanced situations, the foot may need to be immobilized for a time.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome causes a large nerve in the back of the foot to become pinched. Similar to carpal tunnel syndrome in the hand, tarsal tunnel syndrome can cause heel pain.

In addition, other nerve symptoms such as numbness and tingling can occur in people who have this condition.

Stress Fractures

Stress fractures of the calcaneus are an uncommon cause of heel pain. Stress fractures should be considered especially in athletes such as long distance runners who have heel pain. Often these symptoms occur gradually over time, especially when a running is increasing their milage. 

Heel Bursitis 'Pump Bump'

Bursitis is inflammation of a fluid-filled sac that lies between a tendon and bone. Retrocalcaneal bursitis causes pain deep in the back of the heel and is the result of inflammation of a bursa that lies beneath the Achilles tendon where it attaches to the back of the heel bone. Another type of bursitis occurs from the shoe rubbing against a bony prominence on the heel bone. This results in pain, redness, and sometimes swelling on the upper part of the back of the heel.

When to Call the Doctor

If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of heel pain must be directed at the specific cause of your problem. Some signs that you should be seen by a doctor include:

  • Inability to walk comfortably on the affected side
  • Heel pain that occurs at night or while resting
  • Heel pain that persists beyond a few days
  • Swelling or discoloration of the back of the foot
  • Signs of an infection, including fever, redness, warmth
  • Any other unusual symptoms

Treatment

Treatment depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or how severe your condition is, you should seek medical advice before beginning any treatment plan.

Some common treatments are listed here.

Not all of these treatments are appropriate for every condition, but they may be helpful in your situation.

  • Rest
    Avoiding the precipitating activity; for example, take a few day off jogging or prolonged standing/walking. Just resting usually helps to eliminate the most severe pain, and will allow the inflammation to begin to cool down.
  • Apply Ice Packs
    Icing will help to diminish some of the symptoms and control the heel pain. Icing is especially helpful after an acute exacerbation of symptoms.
  • Exercises and Stretches
    Exercises and stretches are designed to relax the tissues that surround the heel bone. Some simple exercises, performed in the morning and evening, often help patients feel better quickly.
  • Anti-Inflammatory Medications
    Anti-inflammatory medications help to both control heel pain and decrease inflammation. Over-the-counter medications are usually sufficient, but prescription options are also available.
  • Shoe Inserts
    Shoe inserts are often the key to successful treatment of heel pain. The shoe inserts often permit patients to continue their routine activities.

A Word From Verywell

Some causes of heel pain are more serious than others. Regardless, your doctor can help you figure out what's causing the discomfort and craft a treatment plan that'll help your specific situation. Most solutions are fairly simple—rest, ice packs, and stretches, for example—that you can do at home without any hassle.

Souces:

Lareau CR, Sawyer G, Wang JH, DiGiovanni CW. "Plantar and medial heel pain: diagnosis and management." J Am Acad Orthop Surg. 2014 Jun;22(6):372-80.

Continue Reading