Some of the most common causes of heel pain are: plantar fasciitis / heel spurs (also known as plantar fasciitis), calcaneal stress fracture, achilles tendinitis, and tarsal tunnel syndrome.
Follow along to learn more about identifying the cause of your heel pain, along with common treatment recommendations for plantar fasciitis and other causes of heel pain.
When Do Your Heel Pain Symptoms Occur?
The timing of your heel pain may provide important information about different heel pain causes. Is your heel pain most severe in the morning or in the evening or does it hurt the same amount all day long?
- Plantar fasciitis will hurt when you get out of bed first thing in the morning or if you have been sitting for any period of time and then stand up.
- Achilles tendinitis will also hurt first thing in the morning and when going from a prolonged sitting position to a standing position.
- Calcaneal stress fractures are just the opposite. The pain will get worse as the foot gets used more. Typically first thing in the morning after a night of rest without any weight bearing, a stress fracture will be less symptomatic in the morning.
- Tarsal tunnel syndrome will cause numbness and tingling typically on the innerside of the heel. Pain with tarsal tunnel syndrome is fairly constant.
What is the Exact Location of your Heel Pain?
Plantar fasciitis pain is located in the bottom part of the foot in the heel region. It is mostly on the inner side of the heel.
Achilles tendinitis is located in the area of the Achilles’ tendon. This is the big tendon located on the back of the heel. It connects your calf muscle to your ankle. It’s a thick cord-like structure in that area.
A calcaneal stress fracture will cause a more diffuse non specific pain involving the heel bone. It may be difficult to pinpoint the exact location of the pain.
Pain from tarsal tunnel syndrome is located on the inner side of the ankle and may have numbness associated with the condition.
Treatment for Different Types of Heel Pain
- Treatment for Plantar Fasciitis: a visit to a physical therapist to work on a stretching program, shoe wear modification, a night splint, oral NSAIDs, orthotics if the foot is pronated (flat), and refraining from walking barefoot. On rare occasion a cortisone shot is given in the area where the plantar fasciitis is present. Surgical resection of the plantar fascia has variable results. PRP treatment is currently being researched. Treatment for plantar fasciitis usually takes 6-8 to work. Recurrence is very common.
- Treatment for Achilles Tendinitis: a visit to a physical therapist, night splint, shoe lift that slightly elevates the heel, and an oral NSAID if not medically contraindicated. Cortisone injections are not recommended in this area because of the risk of tendon rupture.
- Treatment for a Calcaneal Stress Fracture: relative rest. Reduce activity until there is no pain. Crutches / walker / knee walker may be needed. A cast boot may also help to reduce the pain and speed up the healing phase. A bone stimulator can also be used. If there is concern that the patient has poor bone quality that has contributed to the fracture a DEXA scan is recommended.
- Treatment for Tarsal Tunnel Syndrome: physical therapy is recommended, along with a possible cortisone injection. Sometimes surgery is needed to treat tarsal tunnel syndrome.