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Heel Pain

Have pain in your heel and don’t what know what it is? 

Do you want to know why you experiencing heel pain and how to fix?

Heel pain is a common complaint we see and treat at our foot clinics,  36 percent of people will experience it at some point in their lives. But that doesn’t mean it’s a pain you should just deal with. There are simple, non-invasive solutions that can treat your heel pain and help ensure it doesn’t return.

While there are many potential causes behind heel pain, most cases can be managed with a few behavioural changes and helpful orthotics. In rare cases, medicines or surgery might be required. At The Foot Hub, our podiatrists do a thorough evaluation to identify the root cause behind your heel pain and discover a clear path to treat it. Even if your case doesn’t require our orthotics, we offer honest and helpful advice so you can treat the problem quickly and get on with your life, free from pain. 

Read on to learn more about the different causes of heel pain and how we can help you overcome them: 

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What is heel pain?

Heel pain is a common foot symptom that has many possible underlying causes. Heel pain occurs under the heel or behind the heel, where the plantar fascia connects to the heel bone. It is predominantly mechanical in nature i.e how you walk,  however it can also be caused by other conditions.

Causes of heel pain

  • Abnormal gait
  • Foot posture
  • Obesity
  • Ill-fitting shoes
  • Standing, running or junping on hard surfaces
  • Injury to the heel, such as stress fractures
  • Certain disorders, including diabetes and arthritis, infection, poor circulation
  • Cancer or other neurological conditions

Types of heel pain

It’s always important to make sure you have the correct diagnosis for heel pain before starting treatment. Here are some of the main conditions that can cause heel pain:

Plantar fasciitis is the inflammation of a thick band of tissue (plantar fascia) that connects the heel bone to the toes. It is the most common cause of heel pain.

Signs and symptoms include:

  • Pain in the bottom of your foot near the heel.
  • Pain in the heel during your first steps in the morning or after long periods of standing or rest.
  • Pain in the heel after exercise.
plantar-fasciitis

Heel spur is caused by the growth of a bone-like protrusion on the bottom of your heel. It is caused by calcium deposits that extend to the heel bone and the arch. They can grow up to half an inch in length and can only be detected through an x-ray.

Signs and symptoms include:

  • Inflammation and swelling of the front of your heel.
  • Sharp pain.
  • Point of tenderness at the bottom of the heel.
heel spur

Calcaneal stress fracture is a common stress fracture of the heel bone. It is usually caused by repetitive overload to the heel.

Signs and symptoms include:

  • Pain after increasing weight-bearing activities or changing to harder walking surfaces.
  • Pain with activity that progressively worsens to include pain at rest.
  • Diagnosis with imaging.
calcaneal stress fracture

Nerve entrapment can cause heel pain. Nerves in feet can be entrapped as a result of chronic compression when the nerve is squeezed or compacted. It is a condition caused by overuse, trauma, or injury from a previous surgery.

Signs and symptoms include:

  • Sensations of burning, tingling, or numbness.
  • Pain occasionally preceded by increased activity or trauma.
nerve entrapment

Heel pad syndrome is often confused with plantar fasciitis. Patients with heel pad syndrome present with deep, bruise-like pain, usually in the middle of the heel, that can be reproduced with firm palpation.

Signs and symptoms include:

  • Deep, bruise-like pain, usually in the middle of the heel.
  • Tenderness in the middle of your heel, especially when standing or walking.
  • The pain is re-created when pushing the thumb of the hand between the heel of the foot.
heel pad syndrome

Achilles tendinopathy is a condition caused by the repeated injury to the Achilles tendon. It is usually caused by running, wearing high heels, and other activities associated with overuse of the calf muscles.

Signs and symptoms include:

  • Achy, occasionally sharp pain.
  • Pain worsens with increased activity or pressure on the area.
  • Tenderness along the Achilles tendon
  • Occasional palpable prominence from tendon thickening.
achilles tendinopathy

Haglund deformity is a condition caused by the enlargement of the bony structure at the back of the heel due to repeated pressure and rubbing against shoes. It can cause inflammation and swelling and lead to retrocalcaneal bursitis.

Signs and symptoms include:

  • Pain caused by retrocalcaneal bursitis.
  • Positive findings on radiography.
  • Painful bursa (a fluid-filled sac at the back of the foot).
Haglund Deformity

Retrocalcaneal bursitis is a foot condition that causes heel pain spreading from the bursa (or the fluid-filled sac) to between the Achilles tendon and the heel bone. Retrocalcaneal bursitis is caused by the overuse of the heel and ankle area due to increased physical activities.

Signs and symptoms include:

  • Pain, erythema, swelling between the calcaneus and Achilles tendon.
  • Tender to direct palpation.
  • Pain in the calf muscles.
  • Stiffness.
Retrocalcaneal bursitis

Calcaneal Apophysitis, commonly known as Sever’s Disease, is inflammation of the growth plate in the heel bone among physically active children. It can be exacerbated by repetitive stress or from conditions that cause increased tension or traction on the Achilles tendon. It’s more common in children who are taller and heavier.

Signs and symptoms include:

  • Heel pain during or after exercise, especially running.
  • Foot pain in the morning.
  • Limping when walking.
  • Tiptoeing to take pressure off the heel.
children sever's disease

Posterior tibialis tendinopathy is an injury to the posterior tibialis tendon which supports the muscles and bones in the medial arch of the foot.

Signs and symptoms include:

  • Tenderness at the navicular and medial cuneiform.
  • Pain and swelling on the inside of the foot and ankle.
  • Pain on the outside of the ankle.
Posterior Tibialis Tendinopathy

Tarsal tunnel syndrome is a compression, or squeezing, on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve running from the inside of the ankle of the foot.

Signs and symptoms include:

  • Pain and numbness in the posteromedial ankle and heel (may extend into distal sole and toes).
  • Pain worsens with standing, walking, or running.
  • An examination shows positive signs of Tinel.
  • Muscle atrophy may occur if severe.
tarsal tunnel syndrome

Peroneal tendinopathy is a foot condition caused by irritation to one or both peroneal tendons with subsequent degeneration and inflammation.

Signs and symptoms include:

  • Tenderness in the calcaneus or the heel bone that runs across the middle of the foot to the toes.
  • Swelling at the back of the ankle.
  • Pain when turning the foot in and out.
  • The area is warm to touch.
peroneal tendinopathy

Plantar fascia rupture is a condition caused by a painful tear in the plantar fascia. This is a connective tissue that spans across the bottom of the foot. Plantar fascia rupture is often mistaken for plantar fasciitis or calcaneal fracture.

Signs and symptoms include:

  • Sharp pain and a popping sensation as the fascia ruptures.
  • Bruising commonly seen along the middle of the arch.
  • Midfoot that is extremely tender to touch.
  • Trouble walking at all times.
plantar fascia rupture

Podiatrist Sydney

assessment

At The Foot Hub, we understand that heel pain is a complex condition and the importance of getting the correct diagnosis. In your initial assessment your Podiatrist will listen to your medical history and conduct a thorough physical examination.  Clinical assessment is usually enough to diagnosis most conditions, however your Podiatrist can refer for addtional medical imaging if recquired. 

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Treatment

Depending on the cause of your heel pain and severity treatment will vary. Treatment of heel pain can include one or a combination of the following:

Acute

Chronic

preventing heel pain

Different activities and lifestyle habits can lead to heel pain. Prevention is specific to individuals and their activities. Prevention can include the following:

  • Well fitted shoes for comfort and support
  • Activity-specific footwear
  • Strength training
  • Warming up before exercise
  • Diet
  • Rest and breaks between high activity sports
  • Keeping a healthy weight
  • Visit your Podiatrist regualrly for assessments, follow-up appointments and professional advice
  • Consulting with your Podiatrist if you need one

we are here to help you

We know that heel pain can be a deliblitating conditon which can have a negative impact on your quality of life.  We are here to help get back onto your feet pain free.  

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Cost

biomechanical assessment

$200
Initial Appointment
Medical History, Patient History
Footwear Assessment
Treatment Plan
Private Health Insurance Rebates
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* Can be claimed on private health insurance with podiatry cover

frequently asked questions

Heel pain takes about 6 months to resolve depending on severity and the cause. Making sure you have the correct diagnosis and treatment will help with resolution.

Consider wearing shoes with a lower heel for a while to allow symptoms to subside.  Make sure that your heels are comfortable: read our blog to learn more about what features to look for in high heels.

Make sure you have a rubber pad under your feet if you are standing all day at work. Wear shoes with a thick sole and an orthotic with extra cushioning. After work raise your feet for a while. Also, you can soak your feet with warm water and get a soft foot massage with a eucalyptus rub.

Plantar fasciitis is one of the most common causes of heel pain. You may relieve pain temporarily by resting and doing some plantar stretches. Also, wear appropriate footwear for the right occasions that are well-fitted, comfortable, and provide support. If you have chronic plantar fasciitis, treatments such as orthotics, physiotherapy, footwear changes, and shockwave therapy can help.

Post static dyskinesia is a condition that causes heel pain after long periods of rest. The pain is caused when the fibrous band of tissues that run from your toes to your heel on the bottom of your foot are inflamed and tighten when not in use, such as when you sleep or sit for a long period of time. When the time comes for you to stand and put weight on your foot, it pulls on your heel, causing a stabbing pain. This is just temporary pain that subsides when you start walking, but it will recur when you rest again. A tight calf muscle (Achilles tendon complex) is a contributor to the heel pain. stretching the Achilles can improve the tendon.

Yes, tight calves may cause heel pain. Tight calves can put extra strain on the plantar fascia, or the fibrous ligaments at the bottom of the feet that run from the toes to the heel bone, especially when doing extraneous activities as the fascia is meant to take on a small load.

A podiatrist 😊 Sometimes heel pain can require a multidisciplinary approach so other health professionals such physiotherapists, exercise physiologists, radiologists, sports medicine doctors or your GP can be involved.

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