Wapner KL, Parekh SG. Heel pain. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:section F.
Abu-Laban RV, Ho K. Ankle and foot. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 55.
Pain - heel
Heel pain is often the result of overuse of the foot. It is rarely caused by a single injury such as a fall or twist.
Heel pain may include swelling or tenderness. It may be caused by:
- Running, especially on hard surfaces like concrete, or too often
- Tightness in your calf muscles or the Achilles tendon
- Shoes with poor support or shock absorption
- Sudden inward or outward turning of your heel
- Landing hard or awkwardly on the heel
Conditions related to heel pain include:
- Achilles tendinitis, inflammation of the large tendon that connects your calf muscle to your heel.
- Bursitis (inflammation) of the back of the heel)
- Bone spurs in the heel
- Plantar fasciitis, swelling of the thick band of tissue on the bottom of your foot
The following steps may help relieve your heel pain:
- Rest as much as possible for at least a week.
- Apply ice to the painful area. Do this at least twice a day for 10 to 15 minutes, more often in the first couple of days.
- Take acetaminophen or ibuprofen for pain and inflammation.
- Wear proper-fitting shoes.
- A heel cup, felt pads in the heel area, or shoe insert.
Other treatments depend on the cause of your heel pain.
Call your doctor if your heel pain does not get better after 2-3 weeks of home treatments. Also call if:
- Your pain is getting worse despite home treatment
- Your pain is sudden and severe
- You have redness or swelling of your heel
- You cannot put weight on your foot
Your doctor will perform a physical exam and ask questions about your medical history and symptoms, such as:
- Have you had this type of heel pain before?
- When did your pain begin?
- Do you have pain upon your first steps in the morning or after your first steps after rest?
- Is the pain dull and aching or sharp and stabbing?
- Is it worse after exercise?
- Is it worse when standing?
- Did you fall or twist your ankle recently?
- Are you a runner? If so, how far and how often do you run?
- Do you walk or stand for long periods of time?
- What kind of shoes do you wear?
- Do you have any other symptoms?
Your doctor may order a foot x-ray. Treatment depends on the cause of your foot pain. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot. Your doctor may recommend a night splint to help stretch your foot.
Maintaining flexible and strong muscles in your calves, ankles, and feet can help prevent some types of heel pain. Always stretch and warm-up before exercising.
Wear comfortable, properly fitting shoes with good arch support and cushioning.
Review Date: 2/19/2011
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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