Causes of Heel Pain

Medically Reviewed By : Dr K. Hari Chandana

MBBS, MS ORTHOPAEDICS
( Fellowship in Trauma, Fellowship in Pain Management )

Introduction

Heel pain is a common foot problem. It affects everyone, regardless of age or gender. It may occur due to various reasons, such as stepping on sharp objects, injury, repetitive motions of the heel, etc., which will cause swelling and pain in the heel.

Although you might experience pain under, beneath, or behind the heel. And this pain can create hindrances in your daily tasks. 

Thus, it’s important to seek medical advice to know the exact cause of heel pain so that appropriate treatment can begin.

causes of heel pain

What are the Causes of Back Heel Pain?

This problem can occur for various reasons. Such as,

Ankle Pain

Bursitis

It is a painful condition that occurs when the bursae (small fluid-filled sacs that cushion the bones and muscles near the joints) become inflamed. It causes swelling, pain, and stiffness in the affected joint. 

Moreover, repetitive motions or positions that put pressure on the joints are the most common reason for Bursitis. However, it can also occur due to injury or infection.

Achilles Tendinitis

Achilles Tendinitis arises when you irritate and inflame the tendon by overusing or applying repetitive pressure. The Achilles tendon connects the calf muscles to the heel bone, so when it is injured or inflamed, the heel and ankle may become stiff and painful. Additionally, this condition can make it difficult to run or even walk.

Haglund’s Deformity

It is more common in women than men. It usually arises when you run the heel against the back of the shoe, which puts repetitive pressure on the heel.

“Pump bump” is another name for Haglund’s Deformity. It is a bony enlargement on the back of the heel bone that can cause discomfort and pain while wearing shoes.

Sever’s Disease

It is also known as calcaneal apophysitis. This problem mostly affects adolescents and children. Additionally, calcaneal apophysitis is a common condition in younger athletes running or jumping, or if they are wearing shoes that do not provide enough support.

Calcaneal apophysitis occurs when the growth plate (the layer of cartilage near the ends of long bones in adolescents) in the heel bone becomes irritated and inflamed due to repetitive pressure or overuse. 

Because the growth plate is particularly active during childhood, it is vulnerable to injury and inflammation. Thus, it causes pain and swelling in the affected heel.

What are the Reasons for the Pain Beneath the Heel?

Reasons for the pain underneath the heel include:

Plantar Fasciitis

It is one of the most common causes of heel pain in the heel and bottom of the foot. It arises due to poor foot mechanics, repetitive pressure on the foot, or wearing unsupportive shoes.

Plantar Fasciitis occurs when the plantar fascia (a thick band of tissue that runs along the bottom of the foot and connects the heel bone to the toes) becomes inflamed. It eventually causes discomfort and pain in the heel and bottom of the foot. Additionally, it may cause pain while walking or standing for long periods.

This pain may get worse in the morning or after periods of inactivity. It may also be accompanied by tenderness and swelling in the affected area.

plantar fasciitis treatment

Heel Spurs

These are the bony growths that can develop on the underside of the heel bone. However, heel spurs themselves do not usually cause pain. 

However, heel spurs might cause pain when they press against the surrounding soft tissues. Which leads to discomfort and pain in the heel.

Moreover, heel spurs are often associated with Plantar Fasciitis (an inflammation of the band of tissue that runs along the bottom of the foot and connects the heel bone to the toes). They both cause pain early in the morning after periods of inactivity.

Heel Spur
Bone Bruise

A bone bruise or contusion can cause pain beneath the heel if the heel is injured. It can occur due to a direct blow or trauma to the heel; for example, it can result from a fall or sports-related injury.

It is a type of injury that occurs when there is bleeding within the bone, which can lead to swelling, discomfort, and pain. Moreover, this pain can get worse when you walk or stand.

What are Some Rare Causes of Heel Pain?

While most reasons for heel pain are common conditions, as mentioned earlier, some rare causes of heel pain may be less common. For example,

1. Tarsal Tunnel Syndrome

It is a condition in which the tibial nerve in the ankle becomes compressed, causing pain, tingling, and numbness in the heel or foot.

The tibial nerve runs through a narrow tunnel in the ankle called the tarsal tunnel. When this tunnel becomes compressed, it can cause pressure on the nerve, which can lead to heel pain. The pain might be mild to severe, such as burning or shooting pain.

2. Gout

It is a type of arthritis that can cause sudden and severe pain in the joints, including the heel. When uric acid crystals build up in the joints, gout arises. It causes pain, inflammation, and swelling in the joints. 

Gout can cause stabbing pain in the heel. Moreover, it can cause redness, swelling, and warmth in the affected area.

3. Osteomyelitis

It is a bacterial infection that affects the bone and can cause heel pain. This condition occurs when bacteria enter the body through an injury or other source and spread to the bones. 

Moreover, it can affect any bone in the body, including the heel bone. It can cause deep, aching pain in the heel. It may also cause fever, chills, and fatigue.

4. Reiter’s Syndrome

Reiter’s syndrome is a type of reactive arthritis that can cause heel pain. This condition occurs when the body’s immune system reacts to an infection elsewhere in the body instead of in the required place. Thus, it causes inflammation in the joints.

Moreover, it can cause dull aches and throbbing pain in the heel. It might also cause swelling, joint pain, stiffness, and redness in the affected area.

What are the Symptoms?

The symptoms of heel pain can vary depending on the underlying cause of the pain. However, some common symptoms of heel pain may include:

If you are experiencing any of these symptoms, it is important to seek a doctor’s advice for an accurate diagnosis and appropriate treatment.

How do I cure heel pain?

The treatment of heel pain depends on the underlying cause of the pain. Here are some of the most common treatments for heel pain:

1. Rest

Resting the affected foot or ankle can help reduce inflammation and pain.

2. Ice

Heel pain can also be cured by applying ice to the affected area. Also, it reduces swelling and pain.

3. Compression

Wearing a compression bandage or wrap reduces the amount of pressure on the heel. Thus, it will help reduce swelling and provide support to the affected area.

4. Elevation

Elevating your foot can help reduce inflammation and swelling in your heel, which can help relieve pain. Moreover, It can also help improve blood flow to the affected area, which can speed up the healing process.

5. Medications

Some painkillers, like acetaminophen or ibuprofen, can help reduce pain and inflammation. Moreover, prescription medications may also be used in some cases.

6. Physical therapy

Physical therapy may be recommended to help improve flexibility, strength, and range of motion in the affected foot or ankle.

7. Orthotics

Wearing custom-made shoe inserts or orthotics can help provide support and improve foot mechanics.

It can help support your foot. Also, it reduces the amount of pressure on your heel, which can help reduce inflammation and pain. It will consequently help your body heal from heel pain more quickly and prevent further damage.

8. Surgery

In some cases, surgery may be necessary to correct the underlying cause of the heel pain.

Frequently Asked Questions

Yes, heel pain can be cured. The treatment for heel pain depends on the underlying cause of the pain.

Yes. The condition known as diabetic neuropathy, which is nerve damage brought on by high blood sugar levels, is one of the most typical causes of heel pain in people with diabetes.  

This nerve damage can cause pain, tingling, and numbness in the feet, including the heels. 

Furthermore, diabetes can raise the chance of getting plantar fasciitis, a condition that hurts the heel and bottom of the foot.



Heel pain is not typically a sign of cancer. While cancer can cause bone pain, it is not a common cause of heel pain. 

The most common causes of heel pain are plantar fasciitis, Achilles tendonitis, heel spurs, and nerve damage. 

However, it is crucial to seek medical advice if you have severe heel pain to identify the underlying cause of the pain and rule out any serious medical conditions.