Causes
Heel pain is most often the result of overuse. However, it may be caused by an injury.
Your heel may become tender or swollen from:
- Shoes with poor support or shock absorption
- Running on hard surfaces, such as concrete
- Running too often
- Tightness in your calf muscle or the Achilles tendon
- Sudden inward or outward turning of your heel
- Landing hard or awkwardly on your heel
Conditions that may cause heel pain include:
- Swelling and pain in the Achilles tendon
- Swelling of the fluid-filled sac (bursa) at the back of the heel bone under the Achilles tendon (bursitis)
- Bone spurs in the heel
- Swelling of the thick band of tissue on the bottom of your foot (plantar fasciitis)
- Fracture of the heel bone that is related to landing very hard on your heel from a fall (calcaneus fracture)
References
Grear BJ. Disorders of tendons and fascia and adolescent and adult pes planus. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 83.
Kadakia AR, Aiyer AA. Heel pain and plantar fasciitis: hindfoot conditions. In: Miller MD, Thompson SR, eds. DeLee Drez & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 120.
McGee DL. Podiatric procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 51.
What to Expect at Your Office Visit
Your provider will perform a physical exam and ask questions about your medical history and symptoms, such as:
- Have you had this type of heel pain before?
- When did your pain begin?
- Do you have pain upon your first steps in the morning or after your first steps after rest?
- Is the pain dull and aching or sharp and stabbing?
- Is it worse after exercise?
- Is it worse when standing?
- Did you fall or twist your ankle recently?
- Are you a runner? If so, how far and how often do you run?
- Do you walk or stand for long periods of time?
- What kind of shoes do you wear?
- Do you have any other symptoms?
Your provider may order a foot x-ray. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot. Your provider may recommend a night splint to help stretch your foot or place you in a boot to rest your foot. At times, further imaging, like CT scan or MRI may be needed. Surgery may be recommended in some cases.
When to Contact a Medical Professional
Contact your provider if your heel pain does not get better after 2 to 3 weeks of home treatment. Also contact them if:
- Your pain is getting worse despite home treatment.
- Your pain is sudden and severe.
- You have redness or swelling of your heel.
- You cannot put weight on your foot, even after resting.