Heel pain – how to ease it

Your feet work hard, taking your weight as you stand, walk, and move. They can handle a lot, but too much stress can lead to problems, often in your heel, the bony back part of your foot.

Heel pain is the most common issue that affects feet, and it has many possible causes, including exercising too much, or wearing poorly fitting shoes.

Pain is usually felt underneath or behind your heel. Getting it diagnosed and treated could help to prevent longer term issues, such as chronic pain, weight gain, and low mood, if it affects your ability to get around and be active.

Mild heel pain can usually be treated with simple methods at home, but ongoing, severe pain may indicate plantar fasciitis, where the connective tissue at the bottom of your feet tears or stretches – the most common cause of heel pain.

More serious pain may occasionally need to be treated with stronger medication, physical therapy, or even surgery.

What does heel pain feel like?

Heel pain can be a sharp, stabbing pain, or may feel dull and achy, and could be:

• behind your heel, at the back of your foot
• between your arch and your heel
• underneath your heel on the bottom of your foot.

You may also have swelling, redness, tenderness, and pain in your ankle or calf.

Certain symptoms may help your doctor diagnose the cause of your heel pain.

For example:

• stabbing pain when you first step out of bed in the morning, which feels like walking on broken glass, could mean plantar fasciitis
• pain at the back of the heel, as well as in your ankle or calf, may be Achilles tendonitis
• a dull ache in the heel with redness and swelling could mean bursitis
• intense pain and swelling with a snap or pop at the time of injuring your foot could be a heel fracture or ruptured Achilles tendon.

When to get emergency help

Get emergency medical care if:

• you have severe heel pain after an injury
• you heard a snap, popping, or grinding noise at the time
• you feel nauseous, dizzy, or faint
• your ankle or foot has changed shape, or is at a strange angle
• you’re unable to walk.

These could be signs of a broken heel bone or ankle.

What causes it?

The most common cause is plantar fasciitis, where the connective tissue at the bottom of your feet tears or stretches, leading to inflammation.

In bursitis, the fluid-filled sacs in your heel get swollen and inflamed, while an inflamed tendon is the cause of tendonitis.

Conditions involving heel pain may be the result of an injury, or pressure on your feet. For example, you’re at higher risk of heel pain if you:

• are overweight
• spend a lot of time on your feet, or have recently started to stand, walk, or run more than usual
• have recently started exercising on hard surfaces
• do a lot of sport, or specific exercise that puts pressure on your feet, such as ballet, dance, jumping, or running
• wear badly-fitting shoes that are too tight, or not supportive or cushioned enough
• are over 40
• have flat feet or high arches (so your weight is not spread evenly through your foot)
• have arthritis in the foot.

Self-care tips to help

You may be able to ease heel pain at home if your symptoms aren’t severe. For example, you could try:

• resting your foot as much as possible, until it feels better
• applying ice packs (wrap in a towel) to reduce inflammation
• taking pain relief such as anti-inflammatories (ibuprofen) if this is suitable for you
• wearing shoe pads or supports (orthotics) to take pressure off the heel when you stand or walk
• taping your heel for support
• not standing up for too long
• wearing sensible, supportive shoes (not high heels or pointy shoes)
• not walking around barefoot
• exercises to stretch the Achilles tendon (if recommended by your health professional)
• wearing a night splint.

When to see a doctor and getting a diagnosis

Go back to the section When to get emergency help to check which symptoms need immediate medical attention.

You should make an appointment with your healthcare professional if:

• you have severe heel pain and you can’t do your usual activities
• the pain is getting worse, or keeps returning
• you’ve treated the pain at home for 2 weeks, and it hasn’t got better
• you have a tingling feeling or you can’t feel anything (loss of sensation) in your foot
• you have diabetes – meaning foot problems can be more serious.

Your healthcare professional will examine your foot, and may arrange further tests, such as an X-ray or MRI scan, to get a closer look at the bones or soft tissue in the foot.

What are the treatments?

Once your doctor knows what’s causing your heel pain, for example, an injury or condition, they can suggest a treatment plan.

Treatments for heel pain may include:

• steroid injections (for temporary relief)
• a cast or protective shoe or boot
• physical therapy
• antibiotics (for an infection, as in bursitis)
• ultrasound repair (shockwave therapy)
• surgery.

Sometimes, it can take weeks or even months for heel pain to get better, so you may need to be patient.

Can you prevent it?

There are some simple ways to prevent heel pain from coming back. For example:

• wear well-fitting, supportive shoes – especially when exercising
• run on softer surfaces such as grass
• stretch well before and after exercise
• follow any exercises suggested by your health professional
• choose low-impact exercise, such as walking, or swimming
• keep to a healthy weight.