Diagnosing Heel Pain


Heel pain is a common foot problem that can stay with you every step of your day. Many people will experience pain in their heels at some point in their life, and there can be a few different causes for heel pain. Whether you have chronic heel pain, or are feeling pain in your heel for the first time, there are several steps in diagnosing the problem.

Before looking at some of the most common causes of heel pain, it’s important to discuss heel spurs. If you’re suffering from pain in your arches or your heels you may think a heel spur is to blame, however many people who have heel spurs don’t feel any pain from the bony protrusion.


Even among those who have a heel spur and suffer pain, in most cases the pain can be relieved without the costly surgery to remove or repair a heel spur. Pain assumed to be from a heel spur is more likely to be from plantar fasciitis. However, if you can feel the spur or a protrusion through your skin (or other causes of pain have been ruled out) sometimes removing the spur can bring relief. Ultimately, consulting with your doctor is the best way to determine if you need surgery for a heel spur.


Plantar fasciitis is “by far” the most common cause of heel pain, according to Podiatry Today. Heel pain from plantar fasciitis is generally most noticeable first thing when you wake up for the day, or when you first stand up after sitting for long periods. Plantar fasciitis refers to inflammation of your plantar fascia.

The plantar fascia is a band of tissue that runs beneath our feet, connecting your heel and the front of your foot. The hard surfaces we walk or stand on each day wear down the plantar fascia or cause small tears. That damage leads to inflammation, which can cause pain, stiffness and swelling in the area of your heel.

A doctor can usually diagnose plantar fasciitis during an office visit without requiring imaging like an MRI or an X-Ray.

Achilles Tendinitis is another common injury from overuse that can result in heel pain. The most likely culprit for the condition is a sudden increase in physical activity. Runners who step up their workout too quickly can get Achilles tendonitis, and it also occurs among folks who don’t train regularly but play sports occasionally—perhaps only on weekends.

Like plantar fasciitis, the issue here is inflamed tissue causing pain or stiffness—this time in the area of the Achilles tendon. The Achilles tendon is at the back of your leg above the ankle, and it connects muscles in your calf to your heel. This pain may also radiate to the heel.

If you’re noticing an “itis” trend, you won’t be surprised that bursitis is the next possible culprit when it comes to heel pain. Your body has several bursa, which are small sacs of fluid that help cushion tendons, joints and muscles as you move. These bursa are found in many places in your body, including in your heel.

If the bursa in your heel is inflamed you may feel a bruise-like pain. That pain is generally felt most intensely at the back of your heel. Unlike plantar fasciitis or Achilles tendinitis, this pain is more commonly felt at the end of the day. This pain is worse when you stand for long stretches of time and can increase when you bend your foot up and down.


Long-term bursitis can lead to a “pump bump”, which is an abnormal growth of bone at the back of the heel. As the name suggests, the condition is often caused by wearing pumps, high heels, or other tight footwear that lacks proper support for long periods of time.

Heel pain may also be the result of injury or trauma, such as stepping on something sharp or suffering a bruise from an impact, or it may stem from less common issues like a trapped nerve.

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