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Heel pain is a common problem many people face. Whether you’re an athlete or just someone who enjoys walking, heel pain can be frustrating. In this article, we’ll explore why heel pain happens, how doctors diagnose it, and the best ways to treat it.
Why It’s a Common Issue
Heel pain is a common problem that can happen for many reasons. Simple activities like walking, running, or standing for too long can put extra pressure on your heels and cause discomfort. The way you walk and the shoes you wear also make a difference.
Health conditions like diabetes and inflammatory diseases can affect your tendon elasticity and joint health, making heel pain worse. Hormone changes due to pregnancy or menopause and long-term steroid use can weaken bones and tissues, leading to more pain and discomfort.
Common Causes of Heel Pain
Here are some of the most common reasons people feel heel pain:
Plantar Fasciitis
What’s wrong? Breakdown of tissue supporting the arch due to overuse.
Feels like: Stabbing pain in the bottom of the heel, especially first steps in the morning.
Achilles Tendinopathy
What is it? Inflammation of the tendon connecting calf to heel.
Feels like: Pain at the back of the heel, worse after activity or uphill walking.
Learn more about Achilles rehab →Posterior Tibial Tendon Dysfunction (PTTD)
What happened? Damage to the tendon supporting the arch.
Signs: Pain inside the ankle, flattening arch, swelling. Pain worsens after rest.
Other Causes
- • Stress Fractures: Tiny cracks in the heel bone from impact.
- • Heel Spurs: Bone growths causing pain.
- • Bursitis: Inflammation of fluid sacs.
- • Neuropathy: Nerve damage causing numbness.
Is Heel Pain a Sign of Cancer?
It’s rare, as most heel pain comes from common causes.
Symptoms that Might Signal Cancer
- Osteosarcoma: This is a type of bone cancer that usually happens in kids but is very rare in the foot.
- Ewing Sarcoma: A type of cancer that affects children and young adults, often in the bones, including the feet. It's the second most common bone cancer in kids, especially between 5 and 20 years old. It's very rare when it happens in the small bones of the hands and feet.
- Bone Metastasis: Sometimes, cancers like breast cancer can spread to the bones, a condition known as bone metastasis. While it’s unusual, heel pain can be a sign of bone metastasis, particularly when cancer spreads to the heel bone (calcaneus). This is why it's important to take heel pain seriously, especially if it's persistent or accompanied by other symptoms.
Signs to Watch Out For
- If the pain doesn't get better with rest or gets worse over time.
- If you notice a cyst or lump in the area.
- Night pain that doesn’t go away.
- Losing weight for no reason.
- Feeling unwell or sick in general.
For more information, speak to a GP or visit the NHS cancer symptoms page.
Diagnosis of Heel Pain
Physical Exam
A doctor or physio will begin by asking about your symptoms and any activities that could have caused your pain.
Imaging Tests
- X-rays: Check for fractures or bone spurs.
- MRI: Examine soft tissues like ligaments.
- Ultrasound (USS): Check tendon health.
Treatment Options for Heel Pain
Rest & Recovery
Inflammation usually improves within 6 weeks with proper rest, gentle movement, and heat therapy. Avoid uneven surfaces.
Physical Therapy
Stretching: Loosens tight muscles.
Calf Stretching Animation
Orthotics
Wearing the right shoes and special inserts (orthotics) can help spread pressure evenly from your heel to your toes.
Medical
- Shockwave Therapy
- Steroid Injections
- Surgery (Last resort)
How Can I Prevent Heel Pain?
Ways to Make Your Heels More Comfortable
Wearing comfortable, supportive shoes is essential for keeping your heels pain-free. Choose shoes with good arch support and cushioning to help reduce pressure on your feet. If you're dealing with rubbing or discomfort at the back of your heel, look for shoes with a soft, padded heel collar to prevent irritation. Incorporating daily stretching exercises for your calves and feet will also improve flexibility, reduce tightness, and lower your risk of heel pain.
Top Tips to Prevent Shoes Rubbing
If your shoes are rubbing the back of your heel and causing discomfort, make sure you're wearing shoes that fit well and have adequate cushioning. You can also try using heel pads or blister protectors to reduce friction. Additionally, adjusting the shoe’s fit—such as loosening the laces or choosing a shoe with a softer, more flexible material around the heel area—can help prevent rubbing.
Does weight matter?
Maintaining a healthy weight is crucial for reducing stress on your heels. Excess weight puts additional pressure on your feet, which can increase the likelihood of pain and injury. Heel pain can sometimes be a symptom of underlying health conditions, such as diabetes. High blood sugar levels can lead to nerve damage (neuropathy) and poor circulation, which can cause pain in the feet and heels.
Additionally, being mindful of your activity level is important—avoid sudden increases in exercise intensity and give your feet time to recover with rest if you're on your feet for long periods. Gradually ease into new activities and choose lower-impact exercises to help prevent heel pain.
Conclusion
Heel pain is a common issue that can be managed and prevented with the right approach. By taking care of your feet with proper footwear, stretching, and strengthening exercises, you can improve flexibility and reduce discomfort. Managing risk factors like maintaining a healthy weight and being mindful of your activity level can further protect your heels from strain. In some cases, medical interventions such as shockwave therapy, steroid injections, or even surgery may be necessary, but with early intervention and a well-balanced treatment plan, heel pain can often be controlled effectively. By incorporating these preventive measures into your daily routine, you can enjoy more comfort and mobility in your daily activities.
References
- Latt, L. D., Jaffe, D. E., & Taljanovic, M. S. (2020). Evaluation and Treatment of Chronic Plantar Fasciitis. Journal of Foot and Ankle Research. https://doi.org/10.1177/2473011419896763
- Luffy, L., Grosel, J., Thomas, R., & So, E. (2018). Plantar Fasciitis: A Review of Treatments. Journal of the American Academy of Physician Assistants, 31(1), 20-24. https://doi.org/10.1097/01.JAA.0000527695.76041.99
- National Health Service (NHS). (n.d.). Cancer Symptoms. https://www.nhs.uk/conditions/cancer/symptoms/
- Tu, P. (2018). Heel Pain: Diagnosis and Management. American Family Physician, 97(2), 86-93. https://www.aafp.org/pubs/afp/issues/2018/0115/p86.html