Heel pain can feel like throbbing, burning, or stabbing sensations in the back or bottom of your foot. It’s a common complaint that affects people of all ages and activity levels—accounting for more than two million medical visits in the U.S. each year.

This pain often worsens when standing or walking for long periods, which can limit mobility and daily comfort. Ignoring heel pain may lead to complications like bone spurs or foot deformities, so seeking early treatment is essential.

Common Types of Heel Pain

The heel bone, or calcaneus, is the largest bone in the foot and connects with major soft tissues like:

  • The Achilles tendon, which links your calf muscles to the back of your heel.

  • The plantar fascia, a thick ligament running along the sole that forms your foot’s arch.

Pain usually occurs either:

  • At the back of the heel, where the Achilles tendon meets the bone.

  • At the bottom of the heel, where the plantar fascia attaches.

Heel pain can be acute (short-term from injury or strain) or chronic (lasting over three months due to ongoing inflammation or structural issues).

Symptoms of Heel Pain

The exact symptoms depend on the cause, but common signs include:

  • Redness or swelling in the heel area

  • Stiffness after rest or sleep

  • Pain that radiates to the arch or ankle

  • Numbness or tingling sensations

  • Difficulty walking or standing for long periods

  • Worsening discomfort after activity

Main Causes of Heel Pain

There are several possible causes of heel pain, ranging from tissue inflammation to structural or nerve-related issues.

1. Plantar Fasciitis

One of the most common causes, plantar fasciitis occurs when the plantar fascia becomes inflamed due to repetitive strain. This ligament absorbs stress during walking, running, or jumping.

Typical signs include:

  • Sharp or stabbing pain near the heel

  • Pain that’s worse in the morning or after inactivity

  • Temporary relief after walking, followed by stiffness later

Risk factors: flat feet, tight calf muscles, obesity, or long hours standing on hard surfaces.

2. Heel Spurs

A heel spur is a bony growth that develops where the plantar fascia attaches to the heel bone. It often results from long-term strain or inflammation.

Key points:

  • Often linked to plantar fasciitis (up to 70% of cases)

  • Feels like a small stone pressing into your heel

  • Triggered by overuse, poor footwear, or obesity

3. Achilles Tendonitis

This condition involves inflammation of the Achilles tendon—the thick cord connecting calf muscles to the heel. It’s common in athletes and people who suddenly increase activity levels.

Symptoms include:

  • Pain or stiffness at the back of the heel

  • Swelling and tenderness, especially in the morning

  • Difficulty standing on tiptoe

Repetitive stress, tight calves, or unsupportive shoes can worsen symptoms.

 

4. Heel Bursitis

Heel bursitis occurs when the fluid-filled sacs (bursae) near the heel become irritated or inflamed, often due to friction from footwear or arthritis.

Two main types:

  • Inferior calcaneal bursitis: Pain on the bottom of the heel when stepping or running.

  • Retrocalcaneal bursitis: Pain at the back of the heel near the Achilles tendon.

Symptoms include tenderness, swelling, and difficulty moving your ankle freely.

5. Heel Pad Atrophy

The heel pad acts like a natural cushion, absorbing impact when you walk. Over time, this fatty tissue can thin out, reducing its shock-absorbing ability.

Causes: aging, repetitive stress, obesity, or high-impact activities like running.

The pain often feels like bruising in the middle of the heel that worsens throughout the day.

6. Heel Bruise

A heel bruise develops from direct trauma—like stepping on a hard object.
It causes localized pain, tenderness, and mild swelling when putting weight on the heel.

This type of pain usually heals with rest, ice, and proper cushioning.

7. Nerve Compression

When a nerve in the heel—such as the Baxter’s nerve—becomes pinched or compressed, it can cause burning, tingling, or numbness in the heel and arch.

This condition may account for up to 20% of chronic heel pain cases.
Common causes include overuse, flat feet, or structural abnormalities.

8. Sever’s Disease

Affects mostly active children aged 8–12, this condition involves inflammation of the heel’s growth plate.
It causes pain, swelling, and tenderness that worsen during sports or prolonged standing.

Rest, stretching, and supportive shoes are typically effective treatments.

When To See a Healthcare Provider

You should consult a doctor or podiatrist if you experience:

  • Heel pain lasting over two weeks

  • Sudden or severe pain after an injury

  • Swelling or redness

  • Difficulty bearing weight

  • Limited range of motion

Ignoring heel pain may lead to chronic inflammation or structural deformities.

Diagnosis

Your healthcare provider will assess your symptoms and may ask:

  • When and where does the pain occur?

  • Does rest or activity make it better or worse?

  • What type of footwear do you use?

  • Have you had prior foot injuries?

Diagnostic methods may include:

  • Physical exam of heel flexibility and tenderness

  • Gait observation while walking

  • X-rays or ultrasound imaging to identify bone spurs or soft tissue damage

Treatment Options

Treatment depends on the cause and severity but usually begins with non-surgical care.

Non-Surgical Treatments

  • Rest and reduce high-impact activities

  • Apply ice packs for 15–20 minutes several times a day

  • Take NSAIDs (ibuprofen or naproxen) to reduce inflammation

  • Use orthotic heel inserts or cushions for support

  • Stretch calf muscles and plantar fascia daily

  • Wear well-fitted shoes with proper arch support

  • Consider night splints to stretch tissues overnight

  • Try physical therapy for flexibility and strength

Surgical Options

If conservative treatments fail, surgery may be considered:

  • Plantar fasciotomy: Tiny incisions relieve tension in the plantar fascia.

  • Achilles tendon surgery: Removes damaged tissue and corrects deformities.

  • Heel spur removal: Shaves off painful bony growths.

These are typically last-resort options for chronic, unresponsive heel pain.

Alternative and Complementary Therapies

Some supportive treatments may enhance recovery:

  • Shockwave therapy: Uses high-energy sound waves to stimulate healing.

  • Acupuncture: Relieves chronic heel pain through targeted stimulation.

  • Platelet-rich plasma (PRP) therapy: Injects your own platelets to boost tissue repair.

Prevention Tips

  • Wear supportive, cushioned shoes daily

  • Maintain a healthy weight to reduce heel stress

  • Stretch before and after exercise

  • Gradually increase workout intensity

  • Avoid walking barefoot on hard surfaces

Living With Heel Pain

Heel pain can disrupt mobility, but consistent self-care helps most people recover fully.
Follow your treatment plan, stay active with low-impact exercise, and take rest breaks when needed.
With patience and the right care, long-term relief is achievable.