Heel pain is a common problem many people face. Whether you’re an athlete or just someone who enjoys walking, heel pain can be frustrating. In this article, we’ll explore why heel pain happens, how doctors diagnose it, and the best ways to treat it.
Heel pain is a common problem that can happen for many reasons. Simple activities like walking, running, or standing for too long can put extra pressure on your heels and cause discomfort. The way you walk and the shoes you wear also make a difference.
Health conditions like diabetes and inflammatory diseases can affect your tendon elasticity and joint health, making heel pain worse. Hormone changes due to pregnancy or menopause and long-term steroid use can weaken bones and tissues, leading to more pain and discomfort.
Here are some of the most common reasons people feel heel pain:
What’s wrong?Plantar fasciitis occurs due to breakdown and wear-and-tear of the tissue which supports the arch of your foot due to overuse or excessive pressure.
How does it feels like? a stabbing pain or ache in the bottom of the foot or heel. Sometimes, it can also feel like pressing down on a bruise at your medial foot arch.
What happened? It occurs when the posterior tibial tendon, which helps support the arch of your foot, becomes damaged or inflamed.
Any signs? Pain along the inside of the ankle, especially during heel raises or when walking on uneven surfaces. You may also notice swelling and weakness in the foot, along with a flattening of the arch, which may cause limping. The pain can worsen after long periods of rest, such as getting out of bed in the morning or after sitting for a while.
What it is? The tendon that connects your calf to your heel bone becomes inflamed or thickens due to overuse.
How it affects my heel? This causes pain at the back of your heel, especially when climbing uphill. You might experience morning stiffness (less than 30 minutes), and the pain is usually worse at the start but loosens up as you move. The pain tends to worsen towards the end of the day. The Achilles tendon may also feel soft and swollen to the touch.
Want to learn more about treating Achilles tendinopathy? Click here for expert advice and effective solutions!
Is it broken? Tiny cracks in the heel bone can happen due to overuse or high-impact activities.
It’s rare, as most heel pain comes from common causes.
Osteosarcoma: This is a type of bone cancer that usually happens in kids but is very rare in the foot.
Ewing Sarcoma: A type of cancer that affects children and young adults, often in the bones, including the feet. It's the second most common bone cancer in kids, especially between 5 and 20 years old. It's very rare when it happens in the small bones of the hands and feet.
Bone Metastasis: Sometimes, cancers like breast cancer can spread to the bones, a condition known as bone metastasis. While it’s unusual, heel pain can be a sign of bone metastasis, particularly when cancer spreads to the heel bone (calcaneus). This is why it's important to take heel pain seriously, especially if it's persistent or accompanied by other symptoms.
For more information, speak to a GP or visit the NHS cancer symptoms page.
A doctor or physio will begin by asking about your symptoms and any activities that could have caused your pain. This helps them understand what the cause of it.
Inflammation usually improves within 6 weeks with proper rest, gentle movement, and heat therapy. It’s important to avoid activities that put extra strain on your heels, such as walking on uneven surfaces or returning to sports too early. If managed correctly, the pain should not get worse during recovery.
Gentle stretching exercises can help loosen tight muscles and improve flexibility in your feet, reducing discomfort over time.
People have different foot shapes, like high arches, flat feet, or normal arches, and different foot sizes. Wearing the right shoes and special inserts (orthotics) can help spread pressure evenly from your heel to your toes when you walk. They also keep your feet steady, warm, and supported, making walking more comfortable and helping to reduce pain and improve stability.
Wearing comfortable, supportive shoes is essential for keeping your heels pain-free. Choose shoes with good arch support and cushioning to help reduce pressure on your feet. If you're dealing with rubbing or discomfort at the back of your heel, look for shoes with a soft, padded heel collar to prevent irritation. Incorporating daily stretching exercises for your calves and feet will also improve flexibility, reduce tightness, and lower your risk of heel pain.
If your shoes are rubbing the back of your heel and causing discomfort, make sure you're wearing shoes that fit well and have adequate cushioning. You can also try using heel pads or blister protectors to reduce friction. Additionally, adjusting the shoe’s fit—such as loosening the laces or choosing a shoe with a softer, more flexible material around the heel area—can help prevent rubbing.
Maintaining a healthy weight is crucial for reducing stress on your heels. Excess weight puts additional pressure on your feet, which can increase the likelihood of pain and injury. Heel pain can sometimes be a symptom of underlying health conditions, such as diabetes. High blood sugar levels can lead to nerve damage (neuropathy) and poor circulation, which can cause pain in the feet and heels.
Additionally, being mindful of your activity level is important—avoid sudden increases in exercise intensity and give your feet time to recover with rest if you're on your feet for long periods. Gradually ease into new activities and choose lower-impact exercises to help prevent heel pain.
Heel pain is a common issue that can be managed and prevented with the right approach. By taking care of your feet with proper footwear, stretching, and strengthening exercises, you can improve flexibility and reduce discomfort. Managing risk factors like maintaining a healthy weight and being mindful of your activity level can further protect your heels from strain. In some cases, medical interventions such as shockwave therapy, steroid injections, or even surgery may be necessary, but with early intervention and a well-balanced treatment plan, heel pain can often be controlled effectively. By incorporating these preventive measures into your daily routine, you can enjoy more comfort and mobility in your daily activities.
Latt, L. D., Jaffe, D. E., & Taljanovic, M. S. (2020). Evaluation and Treatment of Chronic Plantar Fasciitis. Journal of Foot and Ankle Research. https://doi.org/10.1177/2473011419896763
Luffy, L., Grosel, J., Thomas, R., & So, E. (2018). Plantar Fasciitis: A Review of Treatments. Journal of the American Academy of Physician Assistants, 31(1), 20-24. https://doi.org/10.1097/01.JAA.0000527695.76041.99
National Health Service (NHS). (n.d.). Cancer Symptoms. https://www.nhs.uk/conditions/cancer/symptoms/
Tu, P. (2018). Heel Pain: Diagnosis and Management. American Family Physician, 97(2), 86-93. https://www.aafp.org/pubs/afp/issues/2018/0115/p86.html