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.

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