Heel Pain

What is heel pain?

Heel pain can make even simple tasks — like standing, walking or exercising — uncomfortable and frustrating. You may feel pain along the bottom, back or sides of your heel, and it can develop gradually or after an increase in activity. Many people notice sharp pain with their first steps in the morning that eases as they move, then returns later in the day.

At Novant Health, we understand how heel pain can interfere with your daily routines and the activities you enjoy. Our specialists take the time to listen, identify the cause of your pain and create a personalized care plan designed to relieve discomfort, support healing and help you move more comfortably.

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An X-ray image of a foot showing bones, with the calcaneus bone highlighted.

Anatomy of the heel bone

The heel bone (calcaneus) is the largest bone in the foot and helps absorb impact each time your foot strikes the ground. A strong band of tissue called the plantar fascia runs from the heel bone along the bottom of the foot to the toes, supporting the arch and assisting with push-off during walking or running. The Achilles tendon connects the calf muscles to the back of the heel and plays an important role in balance, stability and forward movement.

When any of these structures become irritated or overloaded, the tissues may swell, stiffen or develop small tears, leading to pain with weight-bearing activities. Over time, chronic strain can contribute to conditions such as heel spurs, tendon thickening or changes in walking patterns, which may place added stress on other joints in the foot, ankle, knee or hip.

Overview

Symptoms

Heel pain symptoms vary based on the underlying cause and may change throughout the day. You may notice:

Sharp, stabbing pain under the heel with your first steps in the morning or after sitting, which may ease with movement and return with prolonged standing or activity
Aching, burning or stiffness along the back of the heel or Achilles tendon, sometimes with swelling, warmth or tenderness
Pain that worsens when climbing stairs, walking barefoot on hard floors, running or wearing unsupportive shoes, and improves with rest or footwear changes

Causes

Heel pain often develops from a combination of overuse, foot structure, and lifestyle factors. Common causes include:

Plantar fasciitis: Irritation or inflammation of the tissue along the bottom of your foot, often caused by overuse, tight calf muscles, high-impact activities or poor arch support
Achilles tendinitis: Overuse or strain of the tendon at the back of your heel, common in runners or people who suddenly increase their activity level
Heel spurs: Small bony growths that may form where the plantar fascia attaches to the heel bone, sometimes linked to long-standing plantar fasciitis
Bursitis: Swelling or irritation of the small fluid-filled sacs that cushion your heel, often caused by repeated pressure or wearing shoes that don’t fit well
Foot structure or stress factors: Flat feet, high arches, or feet that roll inward (overpronation), as well as carrying extra weight or spending long periods standing on hard surfaces, can increase stress on the heel

Diagnosis

Your Novant Health foot and ankle specialist will perform a thorough evaluation to determine the cause of your heel pain. Diagnosis may include:

A detailed physical exam to assess tenderness, swelling, range of motion, strength and walking pattern
Imaging studies when needed, such as X-rays or other advanced imaging, to evaluate heel spurs, stress injuries, joint changes or tendon concerns
Talking with you about your symptoms, medical history, activity level, footwear and prior injuries to create a treatment plan tailored to your needs and goals

Why treatment matters

Early, expert care can help ease symptoms, address underlying causes and reduce the risk of heel pain becoming a long-term problem. Prompt evaluation allows your care team to recommend strategies such as activity modification, footwear and orthotic guidance, stretching and strengthening, and other therapies that support healing and protect foot and ankle structures.

When heel pain is left untreated, it may worsen and begin to interfere with daily activities like walking at work, caring for family or staying active. Over time, changes in how you walk to avoid pain can strain other joints and increase the risk of additional foot, ankle, knee or hip problems.

Take the next step

Our board-certified specialists are here to help you heal. They can often diagnose the problem in one visit and get you started with a personalized treatment plan. We offer a wide variety of treatment options.