What is heel pain?

Heel pain is pain that you feel at or around the heel of your foot. It's often felt underneath or at the back of your heel. This can happen if your heel is used too much. Some activities such as dancing and running can cause damage to your heel.

The most common causes of heel pain are:

• plantar fasciitis
• Achilles tendonitis
• Sever's disease — a common cause of heel pain in growing children

There are many other causes of heel pain, such as arthritis.

What symptoms are related to heel pain?

Heel pain is felt when there is pain around the heel of your foot. Depending on the cause of your heel pain, you may also have:

• bruising
• cramping
• pins and needles
• stiffness
• swelling
• other skin changes

What causes heel pain?

There are different reasons for heel pain.

Plantar fasciitis

Plantar fasciitis is inflammation of the plantar fascia. This is a ligament (a piece of strong, thin tissue) that connects your heel bone to your toes. It runs along the bottom of your foot.

Bruising or overstretching the plantar fascia can cause inflammation and heel pain. Causes of plantar fasciitis include:

• having flat feet or high-arches
• wearing non-supportive footwear on hard surfaces
• playing sports that place a lot of stress on the heel bone
• being overweight, which puts more load onto the plantar fascia

Pain from plantar fasciitis may be worse when you first get out of bed in the morning.

It may also get worse when you start walking after you have been sitting still for a while. The pain is usually felt in the sole of the foot and the bottom of your heel. It usually eases after a few minutes of walking.

Sometimes pregnancy can put strain on the feet causing pain. This can be due to weight gain or hormone changes.

Achilles tendinitis

Achilles tendinitis is another common cause of heel pain.

This is inflammation of the Achilles tendon. This tendon runs from your heel to your calf. This can be caused by tight calf muscles and being used too much.

It often causes pain behind your heel. It might hurt to rise to stand on your toes. It can also cause:

• swelling
• warmth
• tenderness

Gently stretching your calf might help. You may need to see a physiotherapist and do special exercises if pain persists.

Other causes

Arthritis can cause pain in your heel.

Other common causes of heel pain may be:

• blisters, corns or warts
• heel bursitis (inflammation of the back of your heel) the bursa
• bruising on the heel
• stress fracture of the heel bone
• tarsal tunnel syndrome (a pinched nerve)
• osteomyelitis (infection of the bone)

When should I see my doctor?

If you have heel pain symptoms that do not go away, see your doctor. They can refer you to specialists including:

• a physiotherapist
• a podiatrist — allied health professionals trained in foot and lower limb health

It's important to see a doctor if your heel pain comes on suddenly after an injury.

How is heel pain diagnosed?

Doctors, physiotherapists, and podiatrists can diagnose the cause of your heel pain. They will do this by asking you about your symptoms and examining you.

Sometimes they will do:

• an x-ray
• an ultrasound
• an MRI scan

How is heel pain treated?

If you have plantar fasciitis or Achilles tendonitis your doctor may recommend rest and home treatments. These may include stretching exercises at home.

Some exercises are designed to strengthen your calf muscles. Sometimes exercises are needed for the small muscles of your foot.

Initial treatments for heel pain include:

• putting an ice pack where it hurts
• using painkillers such as anti-inflammatory medicines
• losing some weight to reduce the stress on your feet
• night splints or strapping
• stopping the activities that caused your problem
• strapping your foot
• wearing supportive shoes or orthotics

It's important to take time to recover before you return to normal activity or exercise.

How can heel pain be prevented?

Reducing stress on the feet helps to prevent heel injury and pain. This can be done in the following ways.

• Allow your feet to be supported properly with correctly fitted footwear that is suitable for your activity. Footwear that is old and worn might not give your feet the right amount of support.
• Rest your feet if you do a lot of standing, walking or running.
• Maintain a healthy weight. Excess weight puts stress on your feet.
• Exercises to strengthen your calf muscles can help support your feet.
• Stretch and warm-up before exercising to help prevent heel pain.
• Make sure that you have recovery time between your training sessions. Keep hydrated and watch for trip hazards.
• If your feet hurt, stop your activity and rest. This can prevent your injury from getting worse.

Complications of heel pain

It's important to get heel pain treated. Heel pain can prevent you moving freely. It can make walking and running painful and can affect the quality of your daily life.

Some people can have heel pain that lasts for years. It can affect your mood and restrict your enjoyment of outdoor and social activities.

A ruptured Achilles tendon can be a complication of Achilles tendonitis.

Resources and support

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.