Heel Pain Causes

Heel pain causes are numerous and varied, some more obvious than others. The pain, more often than not, is focused on the bottom of the heel area but can occur in the back of the heel. Heel pain can be the cause of a severe condition and so should be considered as warranting the seeking of expert medical attention. Your feet are essential body parts and should be well looked after.

Plantar fasciitis

Plantar fasciitis is probably the most common cause of heel pain and number one in the list of heel pain causes according to the staff at the Mayo Clinic. The plantar fascia is the main ligament of the foot, that stretches between the heel bone and the heads of the metatarsal bones,metatarsal bones are the bones between each of your toes and the bones of the mid foot. The plantar fascia also plays a major role in supporting the arch of the foot. Plantar fasciitis is a condition where the plantar fascia becomes irritated or inflamed (swollen) resulting in pain in the heel area of the foot. The pain from plantar fasciitis is commonly worse first thing in the morning but once the foot warms up with use, may become less intense as the day wears on.

Achilles tendinitis

Achilles tendinitis is a major cause of heel pain. The Achilles tendon (calcaneal tendon) is a thick fibrous band that connects the calf muscle (plantaris gastrocnemius) to the heel bone (calcaneus bone) and is famously named after the mythological warrior Achilles whose only week spot in battle was his heel. The Achilles tendon can rupture and become inflamed, thus causing heel pain on the underside of the heel where the tendon connects to the heel bone as well as pain in the back of the heel. Should the Achilles tendon suffer a total rupture, the sharp pain can also coincide with a popping sound. Achilles tendinitis refers to inflammation of the tendon, Achilles tendon rupture is a partial or total break in the tendon.
Heel bursitis is a swelling of the small fluid-filled sac (bursa) at the rear of the heel bone located under the Achilles tendon, the Achilles tendon connects the calf muscles to the heel bone (calcaneus bone). The bursa acts as a cushion and lubricant between tendons or muscles sliding over bone, like a car’s ball joint. When the bursa becomes irritated or inflamed, maybe due to excessive wear and tear during walking, running, or jumping. The irritation or swelling of the bursa can cause heel pain when walking or running or, especially when standing on tiptoes and may be red in color and sensitive to touch.

Heel spurs (calcaneal spurs)

Heel spurs (calcaneal spurs) are another cause of heel pain as calcium deposits build up on the underside of the heel bone (calcaneus bone). Overtime these calcium deposits can develop into small protrusions on the heel bone itself. These protrusions, though often not painful themselves can irritate the surrounding tissues and cause pain in the heel area of the foot. Being overweight can lead to heel spurs, people with flat feet and women who wear high-heeled shoes frequently are also susceptible to heel spurs. As with plantar fasciitis, the heel pain is sometimes worse, first thing in the morning, reducing in intensity as the day wears on.

Heel pad wear and tear

Heel pad wear and tear is a common cause of heel pain. The “fat pad” underneath the heel bone (calcaneus bone) is a layer of fat that cushions and protects the bone itself, can waste away because of constant use when walking, running or even just standing. This wasting away is known as “fat pad atrophy”. Repetitive strain on the fat pad from excessive exercise or running is a common complaint with athletes and women who have worn high heel shoes for many years may have an increased risk of developing fat pad atrophy.

Tarsal tunnel syndrome

Tarsal tunnel syndrome (posterior tibial neuralgia) or “TTS” for short, is a painful condition of the foot in which the tibial nerve is compressed or trapped as it runs through the tarsal tunnel. The tarsal tunnel is made of bone on the inside and is sheathed by fibrous tissues known as flexor retinaculum, the tarsal tunnel runs inside the inner leg carrying nerves and muscles. When the tibial nerve becomes trapped or compressed pain can result in the heel area of the foot. The pain associated with tarsal tunnel syndrome (posterior tibial neuralgia) can be more acute at night and may be accentuated when under stress or load of walking or running.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic disease that affects multiple joints throughout the body including the joints of the foot. People with this disease have a 90% chance of suffering from pain in the foot directly attributable to rheumatoid arthritis. With rheumatoid arthritis, the immune system actually attacks its own tissues, in the defense of rheumatoid arthritis, the tissues, cartilage and ligaments become damaged and the bones can soften or deteriorate. In about 20% of patients, foot and ankle symptoms are the first signs of rheumatoid arthritis. As the damage occurs heel pain is often a resulting symptom.


Fibromyalgia, according to the Mayo clinic, one of many heel pain causes, “Fibromyalgia is a disorder characterized by widespread musculoskeletal pain, sometimes affecting the feet, accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals”. Though not as common as plantar fasciitis or Achilles tendon issues, Fibromyalgia can be a cause of heel pain.

Heel stress fractures

Heel stress fractures are an obvious cause of heel pain and deserve a mention. Heel pain causes of pain, after any trauma to the feet should be cause for concern and expert medical advice should be sort as soon as possible. Heel pain attributable to fractures in the foot area can be relieved by the use of orthotic insoles, heel pads or cups etc but it is important to seek medical help in case the fractures do not heel correctly or cause more dangerous issues, It is wise to err on the side of caution as your feet are very important and serious issues can cost you quite a lot of money if left untreated.

Baxter’s Nerve Entrapment

Baxter’s Nerve Entrapment. Pinched nerves are one of the primary heel pain causes and can lead to heel pain that is sometimes quite severe. The pinched nerve does not have to be located in the foot to cause heel pain, nerves anywhere in the body can result in pain in the heel area. Issues with the back, especially the lower back, can be a common cause of heel pain. Heel pain combined with leg pain can be due to a back issue, if there is no pain in the legs but heel pain only, then the problem is probably foot related.
Peripheral neuropathy is damage or disease affecting nerves, normally multiple nerves. mono neuropathy is damage or disease affecting a single nerve and is also one of the many heel pain causes. Diabetic Neuropathy may cause a lack of sensitivity , a lack of ability to feel pain, heat, and cold. Obviously such a condition might not be a cause for heel pain but it may cause some diabetic sufferers to miss a foot condition that might otherwise become apparent because of heel pain. Peripheral neuropathy can lead to a severe burning sensation in the feet, especially the heel area of the foot.


Gout is a very painful form of arthritis and is high on the list of heel pain causes. Gout occurs when uric acid builds up in the body in excessive amounts. Gout can be caused by many things including, stress, alcohol or drugs. Many types of medical illness can also be a factor. Gout can affect many areas of the body including the heels, this will lead to heel pain in some cases.
Osteomyelitis is an infection of the bone and marrow not considered a primary culprit in heel pain causes but deserves a mention. Sometimes infection can develop in bones because of a wound or an open sore or can even spread to the foot through the blood. Should osteomyelitis occur in any of the many bones in the feet, heel pain may occur. Bone tumors in any of the bones in the foot can also be a major contributing factor of heel pain.
Heel pain causes a lot of anxiety to the sufferer as well as the family. Heel pain causes time off work, general stress throughout the day and sometimes the night. Heel pain causes can be difficult to pin point and it is always a good idea to consult with a professional. Trying to ascertain heel pain causes can be crucial in any treatment plan options.

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