Heel Pain Causes

By Daniel Wieking, MD

Q. Lately I’ve had a lot of pain in my heel. What causes it and how can I find relief?
A. A common cause of heel pain is plantar fasciitis. Your plantar fascia is a thick, leather like band or ligament spanning the bottom of your foot. It connects your heel bone to your toes and creates the arch in your foot. When this ligament becomes irritated, it usually manifests as heel pain, which is often worse in the morning and can be quite uncomfortable. Doctors still aren’t clear why plantar fasciitis develops in some people and not others. It seems to be related to an excessively tight calf muscle, which is not necessarily associated with an injury.

The good news is that plantar fasciitis almost always gets better. The bad news is that it may take a long time. The majority of people suffering from heel pain improve within a few months, but it can take a year or more. The primary treatment is a stretching regimen that you can do at home. The goal is to loosen the Achilles tendon—the large rope that attaches your heel to your calf muscle. I often recommend stretching for three 30-second periods three times a day.

Orthotics might help as well. Some people find relief from wearing special shoes that lift the heel. Custom or full-length orthotics, however, are often unnecessary and may actually aggravate the condition.

If you suspect your pain is caused by plantar fasciitis, I generally recommend listening to your body and trying some home remedies first. Apply an ice pack to your heel for 20 minutes a few times a day, take over-the-counter anti-inflammatory medications such as ibuprofen, and practice stretching for up to one month.

If the problem persists, or if you are unsure of what’s causing your heel trouble, experienced a recent injury, or just can’t stand the pain, see your primary care doctor. If needed, he or she can refer you to an orthopedic specialist.