Heel pain – causes, treatment

Heel pain

Heel pain has a variety of possible causes. An early visit to the doctor and the associated early start of treatment are important for successful therapy.

What is heel pain?

Heel pain can affect different areas of the human heel. In most cases, heel pain manifests itself comparatively characteristically: The corresponding pain occurs primarily as so-called approach pain. A start-up pain is characterized by the fact that it is most severe when the foot is loaded after longer periods of rest; for example when getting up in the morning.

Athletes in particular are occasionally affected by heel pain. Depending on the period of time for which heel pain has already been present in an affected person, a distinction can be made between acute and chronic heel pain: Chronic heel pain is pain that has been evident for several months.


There are many possible causes of heel pain. In many cases, the pain is due to disorders of the Achilles tendon (the end tendon of the calf muscle and also the strongest tendon in the human body). For example, inflammation, but also overloading or tears in the Achilles tendon can lead to heel pain.

Other possible causes of heel pain are inflammatory processes in the bursa on the heel. A so-called stress fracture (a fracture caused by long-term overload) of the heel bone can also be the cause of heel pain.

Heel pain can also be caused by a strong breakdown of the heel fat pad; the bony structures of the heel are no longer adequately protected from shocks. If a patient has a so-called heel spur (i.e. a thorn-like bony outgrowth), this can also cause heel pain.

Degenerative processes (often age-related) can also have a painful effect on the heel. In some cases, heel pain is also considered an early symptom of chronic conditions, such as ankylosing spondylitis (an autoimmune disease that can lead to curvature of the spine over time ).

diseases with this symptom

Diagnosis & History

In order to diagnose the causes of heel pain, the doctor usually first asks about the medical history of a patient. This medical history includes, for example, previous illnesses or injuries with possible effects on structures of the heel.

As part of a subsequent physical examination for heel pain, factors such as posture, joint mobility, reflexes, muscle strength or gait are often assessed. In order to be able to visualize the internal structures of the heel in the event of heel pain, diagnostic procedures such as ultrasound or X-rays are carried out if necessary.

The course of heel pain mainly depends on the cause of the corresponding pain. If the causes of heel pain can be eliminated medically or by the body’s self-healing powers, the pain usually subsides. If heel pain is based on long-term diseases, the course of the pain is usually related to the course of the underlying disease.


When heel pain occurs, limitations in daily mobility can occur, leading to a sharp reduction in personal range of motion. The way you walk can also change. This subsequently leads to a loss of balance and an increased risk of falling and accidents.

It is also known that heel pain is one of the most common causes of rearfoot problems, which often poses a special therapeutic challenge. Accompanying complaints are also reported by a limited dorsiflexion of the foot. Especially when this is reduced to less than 10 degrees.

If there is plantar fasciitis (tendon plate of the sole of the foot is inflamed) due to overload, heel pain occurs under load and pressure. If this inflammation is not treated in time, it can become chronic. If the heel pain is due to a heel spur, the adjacent soft tissue can become inflamed.

If the treatment is carried out with a surgically performed open indentation, the pain may persist afterwards, reappear after a short period of freedom from symptoms (recurrent pain) or extend to the metatarsus. In addition, there are the normal surgical risks such as infections, painful scars or venous thrombosis. Although embolisms and nerve injuries are very rare, they cannot be completely ruled out. It cannot be ruled out as a complication that there is over- or under-correction or that there is ultimately a lack of attachment of the Achilles tendon attachment after the reconstruction has been carried out, but it is extremely rare.

When should you go to the doctor?

With heel pain, doctors refer to a potpourri of different forms of pain in the heel. In addition to misalignments of the feet, these include bone and nerve problems as well as heel spurs and defects in the Achilles tendon or bursa. How those affected deal with it is as diverse as the causes of heel pain. Some initially regard it as a trifle, while others are already afraid of an operation. Neither is the best attitude towards heel pain. A visit to a doctor, on the other hand, is an excellent idea.

Heel pain should be treated by a specialist, preferably an orthopaedist . When investigating the cause, he will ask exactly the right questions and expertly examine the foot for pressure pain and swelling. Foot malpositions, ill-fitting shoes, one-sided strain, but also obesity can be unmasked as possible causes of heel pain.

Many orthopaedists complain that their patients often only visit them late, when the heel pain has already progressed. The longer the treatment of the heel pain will take. This test of patience and unnecessarily long periods of suffering are saved if you see a doctor immediately with heel pain. A surgeon rarely has to be consulted for heel pain, especially if the doctor’s visit takes place early. A foot is a complicated structure with a demanding task. A healthy heel is an important part of its foundation.

Treatment & Therapy

Therapy measures for heel pain can take two forms: While causal treatment combats the causes of the corresponding pain, symptomatic therapy serves, for example, to alleviate acute pain. Both forms of therapy are often combined in the treatment of heel pain.

The treatment of the causes of heel pain is always based on the individual cause: If heel pain is caused by a heel spur, for example, treatment is usually conservative (without surgical procedures). For example, the influence of vibrating tuning forks on the affected heel can cause calcium deposits in a heel spur to loosen and the spur to recede.

A parallel pain treatment for heel pain in heel spurs can be carried out, for example, with local cold applications, shock wave treatments or pain-relieving drugs that are locally injected (injected). In the case of a partial or complete rupture of the Achilles tendon as the cause of heel pain, healing can be supported by a special shoe that slightly elevates and immobilizes the affected foot.

In some cases, the treatment of heel pain may also require surgical elimination of the cause. In the case of existing underlying diseases, consistent treatment of this disease often has a positive effect on heel pain caused.

Outlook & Forecast

It is relatively difficult to make a prospect or an exact prognosis for heel pain, since the cause of this pain must first be clarified. If it is a heel spur, very unpleasant pain when walking and standing is to be expected. If there is a physical or unusual overload, such a heel spur develops.

When starting up and also with other loads, persistent pain occurs, which is perceived very intensively by the person concerned. If this clinical picture remains untreated, a heel spur will continue to exist. Especially if the overload continues, no improvement is to be expected. A heel spur can only be completely cured with appropriate treatment and a longer period of rest.

However, if the heel pain is caused by a fracture , medical treatment is essential. If a fracture remains completely untreated, there is a risk of severe inflammation , which in the worst case can even cause blood poisoning . Of course, with proper treatment and care, a fracture can heal completely within a few weeks. Immobilization of the respective foot accelerates the entire healing process.


Heel pain as a result of a long-term illness can be prevented above all by consistent therapy of the underlying disease. Heel pain as a result of physical overload can be prevented, for example, by warming up before exercising and an individually tailored training program. Heel pain as a result of acute injuries can only be prevented to a limited extent.

You can do that yourself

Various measures help to relieve heel pain and prevent further pain. If patients with heel pain are overweight , they should reduce their body weight. A body weight in the normal range and a healthy metabolism is easy on the joints. Good blood circulation is important . A healthy and balanced diet , avoiding nicotine and regular physical activity promote blood circulation and thus relieve heel pain.

Feet should be cared for regularly . This includes suitable footwear in everyday life and for sports and at any time of the year. Shoes and stockings should be changed daily. Breathable textiles are also recommended. Calluses from calluses can cause heel pain. If calluses are present, they should be rubbed down with a suitable file or pumice stone. A nourishing cream is also helpful. A lukewarm foot bath with a little salt is helpful to make the skin more supple. Diabetics should never remove calluses themselves, but seek professional foot care.

Walking barefoot is healthy and can relieve heel pain, provided there are no foot problems to prevent it or there are increased risks, for example for diabetics. However, walking barefoot is not recommended in sports halls, swimming pools and saunas. Gymnastics are recommended for patients with heel pain . Specific foot exercises help strengthen the arch of the foot and stretch tendons and muscles.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.