Heel pain

Alternative Names

Home Care

• 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 for pain or ibuprofen for pain and inflammation.
• Wear proper-fitting shoes.
• A heel cup, felt pads in the heel area, or an orthotic device may help.
• Night splints can help some types of heel pain.

Additional steps:

• Apply moleskin to avoid pressure if you have bursitis.
• See a physical therapist to learn stretching and strengthening exercises. These help prevent plantar fasciitis or Achilles tendinitis from returning.

When to Contact a Medical Professional

• Your pain is getting worse despite home treatment
• There is little progress after 2 to 3 weeks of home treatment
• Your pain is sudden and severe
• You have redness or swelling of your heel or you cannot bear weight

Your doctor will take your medical history and perform a physical examination, including a full exam of your feet and legs.

To help diagnose the cause of the problem, your doctor will ask medical history questions, such as:

• Have you have had this type of heel pain before? If so, what was the diagnosis and what caused the problem?
• When did this episode of pain begin?
• Where exactly is your pain?
• Is the pain dull and aching or sharp and stabbing?
• Is it worse after you exercise?
• Is it worse when you are standing?
• Do you have any swelling or redness of your heel?
• Have you had a fall or have you twisted your foot recently?
• Are you a runner? How far do you run? How often do you run? On what type of surface do you run?
• Do you walk or stand on your feet for long periods of time?
• What kind of shoes do you wear?
• Do you have any other symptoms?

Diagnostic tests that may be performed include a foot x-ray, focusing on the heel.

If either plantar fasciitis or bursitis is diagnosed and if shoe changes and the use of orthotics have not been successful, cortisone injections may be tried. Surgery is a last resort and is seldom necessary.

If Achilles tendinitis is diagnosed, anti-inflammatory medicine may be prescribed. Heel lifts may be used. In particularly unresponsive cases, a walking cast may be helpful. Surgery is not usually necessary.

Prevention

To prevent plantar fasciitis and Achilles tendinitis, maintain flexible and strong muscles in your calves, ankles, and feet. Always stretch and warm-up prior to athletic activities.

Wear comfortable, properly fitting shoes with good arch support and cushioning. If you pronate, look for athletic shoes with an antipronation device. If orthotics are prescribed by your provider, wear them in all of your shoes, not just while exercising.

References

Schroeder BM. American College of Foot and Ankle Surgeons: Diagnosis and treatment of heel pain. Am Fam Physician. 2002; 65(8): 1686, 1688.

American College of Radiology (ACR), Expert Panel on Musculoskeletal Imaging. Chronic foot pain. Reston, VA: American College of Radiology; 2002.