What Causes Heel Pain? And What Can I Do About It?

Some of the most common conditions we diagnose include:

Plantar fasciitis

This is the single most common heel pain condition for American adults.

Your arches are supported by a long band of thick ligament tissue that runs from the front of the heel bone to the base of the toes. This ligament is called the plantar fascia.

When irritated and pulled by constant pressure, the plantar fascia can stretch and tear, causing inflammation and pain. This is usually located right near the point where the plantar fascia connects to your heel bone, underneath your foot.

People who suffer from plantar fasciitis often experience the worst pain when standing for the first time after getting out of bed, or getting up from the couch after watching a movie or reading a book.

Heel spurs

Heel spurs are bony growths of deposited calcium that build up on the surface of your heel bone. The most common type of heel spur extends forward from the bottom of the heel bone, and can reach up to half an inch in length.

Usually, heel spurs occur because you have a chronic case of plantar fasciitis that hasn’t been treated. The stretching and tearing away of the plantar fascia from the heel bone is what allows the calcium to begin to deposit. For this reason, heel spurs are often (but not always!) found in conjunction with plantar fasciitis.

Heel spurs do not always cause heel pain. Usually, pain goes away once the plantar fasciitis has been treated. However, if a heel spur is particularly long or pressing on a sensitive area of tissue, it may need to be treated independently.

Achilles tendinitis

The Achilles tendon, or “heel cord,” connects the calf muscle at the back of the leg to the heel. It plays an important role in helping you stand, walk, run, and jump. But even though it’s the body’s thickest and strongest tendon, it’s also vulnerable to injury due to the high stress loads it must handle.

Overuse can cause the tendon to become stretched, torn, or inflamed near where it inserts into the heel bone, at the back of the heel. Common symptoms include pain and stiffness after activity.

Bursitis

Bursae are small, thin, fluid-filled sacs that are strategically positioned near most joints, including the ankles. Their job is to provide cushioning between the bones in a joint so there’s less friction and smoother movement.

There is a bursa located between the Achilles tendon and the heel bone, and similar to Achilles tendinitis, repetitive trauma can cause the bursa to swell painfully.

Haglund’s deformity

Just like chronic plantar fasciitis can cause heel spurs, chronic bursitis and/or Achilles tendinitis can result in the growth of a bony bump at the back of the heel.

Haglund’s deformity is also commonly known as “pump bump,” since it’s especially associated with high-heeled, “pump” style shoes. However, any footwear with an especially hard or tight heel back—such as work boots or ice skates—can produce the same effect.

Sever’s Disease

This is not actually a disease, but an injury that exclusively affects children—especially active adolescents.

While a child is still growing, the ends of many bones are covered by a “growth plate,” which is an area of softer tissue responsible for growing new bone tissue. When the skeleton reaches maturity, the growth plates are covered up, but during childhood and adolescence they remain more exposed and vulnerable.

One of these growth plates is located at the back of the heel bone, and active kids may sometimes irritate or injure it due to overuse. Fortunately, the condition usually corrects on its own if your child just rests from high-impact athletes for a couple of weeks. However, failure to treat the cause can lead to longer-term discomfort.

It’s important to understand that diagnoses and causes are separate things. Two people may both have plantar fasciitis, for example, but the underlying factors that caused their condition might be quite different.

Some of the most common underlying causes of heel pain include:

Obesity

Obesity rates have continued to skyrocket in Texas (and across the United States). Today, more than 1 in 3 adults are considered obese, and more than half are overweight.

Our increase in size means increased pressure on the feet and heels every time we stand or walk. That extra force adds up, and quickly leads to foot fatigue and heel pain.

Poor foot mechanics or structure

No two sets of feet are exactly alike. And unfortunately, some feet are not as well designed for absorbing shock and pressure as others.

If you have feet with flat arches, or that roll too far inward when bearing weight, or have any other kind of mechanical deformity or abnormality, the result may be extra weight and pressure on the heels.

Poor shoe gear

If your shoes are not the right size or not appropriate for the activity you are performing, your heels can quickly tire out or become injured. Your shoes should always fit your feet and your activity.

Beyond that, though, many shoes just don’t offer enough support for the arch or heels that you really need to go about your day without pain. This is especially true if you do have flat feet, or another foot deformity or gait imbalance. (This is where a set of medical-grade inserts can make a huge difference for you.)

Prolonged standing

Although the human body is designed for plenty of standing and walking, you should remember to take regular breaks to rest your feet throughout the day whenever possible.

Obviously, this can be tricky for people who work on their feet, and we have a lot of them here in our community—teachers, factory workers, health care professionals, and more. If you find you’re dealing with a lot of heel pain in these professions, see what kinds of accommodations you can make—for example a stool or a cushioned mat at your workstation.

Finding Relief for Your Heel Pain