Everything You Need to Know About Heel Pain

Heel pain is the usual complaint that primary care physicians encounter. The human feet can handle heavy loads. However, too much stress can push them above their limits. Heel pain is among the most common problems that affect the foot and ankle.

The Causes of Heel Pain

Heel pain is caused by a number of foot and ankle conditions. The conditions fall into two broad categories depending on the location of the pain:

· Pain Beneath the Heel – Pain occurring beneath your heel can be caused by conditions that result in inflammation of the tissues at the bottom of your foot. These conditions include plantar fasciitis (subcalcaneal pain) and heel spur. Plantar fasciitis is the most known cause of heel pain.

· Pain Behind the Heel – Pain in the back of the heel is commonly caused by inflammation of the area where the Achilles tendon inserts into your heel bone (Achilles tendon pain). This condition occurs when you wear shoes that rub the back of your heel or run too much.

What is Plantar Fasciitis?

Plantar fasciitis, the most common cause of heel pain, the inflammation of the band of tissue that connects your heel and toes (plantar fascia). This connective tissue helps in support of the arch of your foot. Plantar fasciitis causes pain in your heel and the bottom of your foot. The pain is most severe in the mornings with your first steps or after periods of rest. Typically, it comes on gradually and affects both feet in approximately one-third of cases.

The risk factors of plantar fasciitis include overuse, a sudden increase in exercise intensity, obesity, calf pain in the muscles, and a sedentary lifestyle. A bone spur in the heel is common in individuals with this condition. Plantar fasciitis is commonly associated with biomechanical defects on the foot. People with either high-arched feet or overly flat feet are more susceptible to the condition. In addition, improper footwear worn on hard, flat surfaces strains the plantar fascia and can lead to plantar fasciitis.

The symptoms associated with this condition include:

· Pain on the lower side of the foot close to the heel

· Pain in the arch of the foot

· Pain occurring within the first few steps after waking up or following long rest periods. The pain usually subsides after several minutes of walking.

· Increased pain after physical activity.

· Swelling on the bottom of the heel

Note that there are some rare, but reported symptoms that may include numbness, tingling or radiating pain in the heel.


The diagnosis of plantar fasciitis involves a physical examination of your foot and medical history assessment by a foot and ankle surgeon. The surgeon will rule out any possible cause of your heel pain aside from plantar fasciitis. Imaging tests can be ordered to confirm this.

X-rays are helpful in ruling out other causes of heel pain like arthritis or fractures. X-rays can also help detect heel spurs. Bone spur heel is common in plantar fasciitis patients, but are rarely the source of the pain. When heel spurs are present, the condition can be diagnosed as heel spur syndrome.

Treatment Options


Most patients with heel pain from this condition show improvements with simple non-surgical treatment that may include:

· Rest – Stopping or reducing activities that worsen the pain, especially high impact activities, can provide relief.

· Ice – Rolling the foot over ice or even cold bottle water for like 20 minutes is effective

· Stretching Exercises – The condition is aggravated by tight calves and foot muscles. Exercises such as calf and plantar fascia stretches provide pain relief.

· Non-Steroidal Anti-Inflammatory Drugs – NSAIDs such as ibuprofen and naproxen may be prescribed to reduce inflammation and pain.

· Shoe Modifications – Supportive footwear with proper arch support and raised heels reduce the strain on the plantar fascia.

· Orthotic Devices – Orthotic devices fitted into your shoes help mitigate the biomechanical foot defects that cause plantar fasciitis

· Night Splints – Most people sleep with their feet pointed down. This means that the plantar fascia is relaxed and thus causes the morning heel pain. Night splints help stretch the plantar fascia during sleep thus alleviates the morning pain.

· Cortisone Injections – Cortisone is a powerful steroidal anti-inflammatory medication that your podiatrist may recommend in some cases.

Surgical Options

Surgery is usually considered after non-surgical options fail to improve symptoms after 12 months. At Frederick Foot and Ankle, our podiatrists will discuss the available surgical options with you and take the most appropriate approach for your condition.

Prevention is usually the best cause of action for heel pain. The underlying cause can remain regardless of the treatment options. Long-term management involves regular stretching, wearing supportive footwear and using orthotic devices.

At Frederick Foot and Ankle, we have a selection of supportive footwear products and custom orthotic devices. You can CONTACT US today if you might have any of the symptoms of plantar fasciitis for early diagnosis and treatment.

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