Heel Pain
Heel pain is a common problem that can affect daily movement and comfort. The most frequent causes include plantar fasciitis, Achilles tendinitis, heel spurs, and bursitis. Overuse, injury, or changes in foot structure often trigger these conditions, making walking or standing for long periods uncomfortable.
Heel pain can start suddenly after intense activity or build up slowly over weeks. Sports, long hours on hard surfaces, or medical conditions like arthritis may contribute. Knowing the exact cause matters because treatment depends on what is happening inside the foot.
Definition of Symptom
Heel pain is discomfort in or around the heel area of the foot. It can affect the bottom, back, or sides of the heel depending on the cause. This symptom may develop suddenly after an injury or appear gradually over time. It can be mild and occasional or persistent and severe enough to limit movement. Common structures linked to heel pain include:
| Structure | Location | Role in Foot Function |
|---|---|---|
| Plantar Fascia | Bottom of foot | Supports the arch and absorbs shock |
| Achilles Tendon | Back of the heel | Connects calf muscles to the heel bone |
| Heel Bone (Calcaneus) | Base of the foot | Bears most body weight during standing and walking |
People often describe heel discomfort as sharp, aching, or throbbing. The sensation may worsen after long periods of standing, walking, or running. Heel pain can affect both active individuals and those with more sedentary lifestyles.
Overuse, poor footwear, or conditions that impact bones, tendons, or ligaments may all play a role. Sometimes, the pain comes from inflammation of the plantar fascia or irritation of the Achilles tendon. Other causes may include stress fractures, bursitis, or nerve compression.
Possible Causes/Diseases Condition
Several conditions affecting the bones, tendons, ligaments, or growth plates in the foot can cause heel pain. Pinpointing the cause helps guide the right treatment.
- Plantar fasciitis is one of the most common causes. When the plantar fascia, a thick band under the foot, becomes irritated or inflamed, pain usually appears under the heel, especially in the morning.
- Achilles tendinitis affects the tendon at the back of the heel and often develops from overuse, such as running or jumping. Swelling and stiffness may occur along with pain.
- Bursitis involves inflammation of the bursa, a small fluid-filled sac near the heel, often from repeated pressure or injury.
- A heel spur is a bony growth on the underside of the heel bone. It may develop alongside plantar fasciitis but does not always cause pain.
- Stress fractures are small cracks in the heel bone caused by repetitive force, often from high-impact sports or sudden increases in activity.
- Calcaneal apophysitis (also called Sever’s disease) affects children and teens during growth spurts. It causes pain at the back or bottom of the heel due to irritation at the growth plate.
- Overuse injuries from prolonged standing, walking, or sports can strain heel structures and may lead to inflammation or small tears in tissues.
| Condition | Common Location of Pain | Typical Cause |
|---|---|---|
| Plantar fasciitis | Bottom of heel | Strain/inflammation of plantar fascia |
| Achilles tendinitis | Back of heel | Overuse, tendon strain |
| Bursitis | Back or bottom of heel | Pressure, injury |
| Heel spur | Bottom of heel | Bone growth, often with plantar fasciitis |
| Stress fracture | Heel bone | Repetitive impact |
| Sever’s disease | Back of heel | Growth plate irritation |
Other Non-Disease Causes
Heel pain can also develop from factors not related to disease or infection. Lifestyle habits, foot structure, or repetitive strain often play a role. Foot structure issues such as flat feet or high arches can place uneven pressure on the heel, leading to irritation over time, especially without proper support.
Wearing unsupportive footwear is another common factor. Shoes without cushioning or arch support can increase stress on the heel during walking or standing. Obesity adds extra load to the feet, which can strain the heel’s soft tissues. Even moderate weight gain can increase heel discomfort in people who stand for long periods.
Repetitive activities like running, jumping, or long-distance walking can cause overuse injuries. Without rest or proper stretching, small strains can build up and cause pain.
How It Causes the Symptom
Irritated or injured tissues, tendons, or bones in the heel often cause pain. Repeated stress, overuse, or sudden strain can lead to small tears or inflammation. Plantar fasciitis develops when the plantar fascia, the thick band along the bottom of the foot, becomes inflamed. This inflammation can cause sharp pain, especially during the first steps after rest.
Achilles tendinitis affects the tendon at the back of the heel. Tight calf muscles, overtraining, or poor footwear can make the tendon swell, stiffen, and become tender. Sometimes, scar tissue forms after repeated injury or surgery. This tissue can limit flexibility and press on surrounding nerves, leading to ongoing discomfort. Other causes include:
- Heel spurs – calcium deposits that create a bony growth under the heel.
- Bursitis – swelling of the fluid-filled sac near the heel bone.
- Sever’s disease – growth plate irritation in children and teens.
| Condition | Main Structure Affected | Typical Pain Location |
|---|---|---|
| Plantar fasciitis | Plantar fascia ligament | Bottom of heel |
| Achilles tendinitis | Achilles tendon | Back of heel |
| Heel spur | Heel bone | Bottom of heel |
| Bursitis | Bursa sac | Back or underside |
Possible Complications
Ignoring heel pain can change how a person walks and place extra strain on the knees, hips, or lower back, causing new areas of pain. Chronic heel pain can limit movement and daily activity. Reduced activity may lead to muscle weakness, stiffness, and lower overall fitness.
Some conditions, such as plantar fasciitis or Achilles tendinitis, can get worse over time, resulting in more persistent pain or swelling that becomes harder to manage. Possible complications include:
- Joint strain from altered walking patterns.
- Bursitis (inflammation of the fluid-filled sac at the heel).
- Heel spurs that cause ongoing discomfort.
- Tendon damage that reduces ankle strength.
| Potential Complication | Possible Effect |
|---|---|
| Gait changes | Pain in knees, hips, or back |
| Muscle weakness | Reduced stability and mobility |
| Heel spurs | Sharp or aching heel pain |
| Tendon injury | Limited ankle movement |
People with chronic conditions like arthritis or diabetes may face a higher risk of slow healing and infection if heel pain is linked to an injury.
When to Seek Medical Attention
Heel pain often improves with rest, stretching, and supportive footwear. However, some symptoms can signal a more serious issue that needs professional care. Contact a doctor if the pain is severe, sudden, or happens after an injury such as a fall or twist. These signs may point to a fracture or tendon injury.
If pain does not improve after several weeks of home care, see a healthcare provider. Ongoing discomfort may be related to conditions like plantar fasciitis or Achilles tendinitis. See a doctor if heel pain comes with:
- Swelling, redness, or warmth in the heel.
- Numbness or tingling in the foot.
- Difficulty walking or putting weight on the foot.
- Visible deformity of the heel or ankle.
If heel pain happens along with fever or signs of infection, such as skin changes or drainage, get medical help promptly. A podiatrist or orthopedic specialist can examine your foot, order imaging if needed, and suggest treatments such as physical therapy, shoe inserts, or medicine. In rare cases, ignoring heel pain may make it worse or cause changes in how you walk, which can strain other parts of the body.
