The Most Common Causes of Heel Pain (and When to Seek Help)
Heel pain is something that around 1 in 10 adults will experience at some point in their life, and there are several things that could cause it. In this blog, we will have a look at the most common causes, when it’s a good idea to seek help, and which treatments are likely to be prescribed.
Plantar Fasciitis
One of the most common conditions that can cause pain in the heel is Plantar Fasciitis. You may have heard of it, but what exactly is it, and how do you know if you have it?
Plantar fasciitis is a condition affecting the thick band of tissue (the plantar fascia) that runs along the bottom of your foot, connecting your heel bone to the base of your toes. It is often associated with repetitive strain and changes in the tissue, and can also be influenced by
factors such as foot shape, age (it’s most common between ages 40 and 60), and weight. Plantar heel pain accounts for around a quarter of foot disorders in athletes.
Common symptoms include sharp pain in the heel/bottom of the foot, and this pain is often worse first thing in the morning or after a period of sitting/resting. It can be triggered or aggravated by increased activity, prolonged standing, running, hard surfaces or inadequate footwear.
Achilles Tendon Problems
If the pain is at the back of the heel, rather than underneath, this could point to an achilles tendon issue. This typically causes pain at the back of the heel/ankle, stiffness or pain after activity, and may be the result of increased running, jumping, or other similar activities.
Achilles tendon problems are often overuse injuries, occurring when the demands placed on the tendon exceed its ability to recover. They can be triggered by a sudden increase in exercise intensity, tight calf muscles, or activities such as running on hills.
Additionally, factors such as foot mechanics, age-related changes in the tendon, worn-out footwear, and certain medications can increase the risk of developing Achilles tendon problems.
Heel Pad Problems
If you’re experiencing a deep, bruised or aching pain directly under the centre of the heel, this could be coming from the heel pad, especially if you notice it more after prolonged standing on hard surfaces.
Heel pad pain is primarily caused by the gradual thinning, bruising, or inflammation of the protective fatty cushion under the heel bone, often due to aging, high-impact activities, prolonged standing on hard surfaces, or sudden trauma.
One way heel pad problems may differ from plantar fasciitis is in the location and nature of the pain. Heel pad pain is often felt directly beneath the centre of the heel and may be worse when standing on hard surfaces. Plantar fasciitis, on the other hand, commonly causes pain with the first steps in the morning or after resting. However, symptoms can overlap, so a professional assessment may be needed to identify the cause.
Other possible causes
There are some other less common, but still possible causes of heel pain. Other potential diagnoses could be:
Bursitis – inflammation of a small fluid-filled sac around the heel.
Stress fracture – can cause increasing heel pain, particularly after increased activity.
Nerve irritation – may cause burning, tingling, numbness or shooting pain.
Arthritis – can affect joints around the foot and ankle.
Injury/fracture – particularly where pain starts suddenly following an accident.
Why does heel pain happen?
Heel pain can be triggered by a number of factors, including a sudden increase in activity, repetitive impact, or long periods of standing and walking, especially on hard surfaces. Tight calf muscles, footwear, weight and foot mechanics may also contribute, depending on the underlying cause.
When should you seek help?
Consider getting professional advice if:
The pain is severe or affecting normal activities.
It is getting worse or repeatedly coming back.
It hasn't improved after around 2 weeks of self-care.
You have tingling, numbness or weakness.
You have diabetes and develop heel/foot pain.
Seek urgent medical attention if:
Severe pain follows an injury.
You heard a snap, pop or grinding sound.
You cannot walk or put weight through the foot.
The foot/ankle looks deformed.
There is significant swelling or bruising.
You experience sudden severe heel pain or inability to bear weight
The heel is hot, red and swollen, particularly if you also have a fever.
How can a professional help?
Because several different conditions can cause heel pain, identifying the likely cause is an important first step. A physiotherapy or biomechanical assessment can help assess the way the feet, ankles, knees and hips are functioning and determine whether factors such as foot mechanics, muscle tightness or loading patterns could be contributing.
The best treatment will depend on the cause, and may include exercise/physiotherapy, footwear advice, insoles or orthotics where appropriate.
If you're experiencing heel pain and would like advice, or would like to book an assessment, please get in touch with us by phone or email. We'd be more than happy to help!
Contact us: hello@comfootzone.co.uk | 01903 532159
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