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Heel Pain: Causes, Prevention and Diagnosis


Heel pain is a very common foot problem now a days. The patients usually feels pain either just behind the heel or under the heel, where the Achilles tendon connects to the heel bone.

Even though heel pain can be severe and sometimes it disabling, then it is rarely a health threat. Heel pain is typically mild and usually, disappears on its own; but, in some cases the pain may persist and become chronic (for long-term).
26 bones are in the human foot, in which the heel is the largest. The human heel is designed to provide a strong support for the weight of the body. When we are walking or running, it absorbs the impact of the foot when it hits the ground, and springs us forward into our next move. Consequently, the heel is vulnerable to damage, and ultimately pain. 

In the majority of cases, heel pain has a mechanical cause. It may also be caused by arthritis, infection, an autoimmune problem trauma, a neurological problem, or some other systemic condition.

The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fasciitis.

Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when one’s job requires long hours on the feet. Obesity may also contribute to plantar fasciitis.

The symptoms of plantar fasciitis are:

  1. Pain on the bottom of the heel
  2. Pain in the arch of the foot
  3. Pain that is usually worse upon arising
  4. Pain that increases over a period of months

People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they’ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.

To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain other than plantar fasciitis.

In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.


Francis J. Smith, D.P.M., A.B.F.A.S.
Board certified in Foot Surgery and Michael A. Klein, D.P.M. A.B.F.A.S.
Board certified in Foot Surgery​

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