Written by a foot and ankle surgeon
Heel pain, explained properly.
Heel pain has several possible causes, and treatments differ. Start with where and when it hurts, explore the common possibilities, and learn when to get examined.
Where does it hurt?
Underneath, worst first thing
Sharp pain on the first steps out of bed that eases as you walk, and returns after a long day. The classic pattern.
At the back of the heel
Stiff and sore in the morning, warms up with activity. Where exactly it is tender decides the treatment — and one type gets worse with the standard exercise.
Somebody mentioned a spur
An X-ray finding that looks like an answer. In most people it is a record of the problem rather than the cause of it.
Not sure which you have
Bruise-like in the middle? Burning? Getting worse the longer you are on it? Those are different problems with different answers.
The three things this site will always tell you
Heel pain is not one condition. Plantar fasciitis is the most common cause, not the only one, and a heel that is not responding to fascia treatment is often not a fascia problem at all.
The spur is usually not the point. Calcaneal spurs turn up in plenty of feet that do not hurt, and spur size does not track with pain.
It takes months, and we will not pretend otherwise. Most plantar heel pain settles without surgery, but on a timescale of months rather than days. What shortens it is starting early and being consistent, not finding a better gadget.
Free 14-day plan
The Heel Pain Playbook
Dr. Tom’s plan for plantar fasciitis, in the order he gives it in the exam room: the warning signs, a pain map, five moves and a tracker. The 19-page plan is free, with no sign-up.
Where to go next
Understand it
- Heel pain causes, by location
- Plantar fasciitis explained
- Achilles tendonitis
- Back of heel pain: which cause is it?
- Heel spurs
- Heel bursitis
- Heel fat pad atrophy
- Burning heel pain (nerve)
- Heel stress fracture
- Sudden heel pain without injury
- Plantar fascia tear
- Sever’s disease (children)
- Haglund’s deformity
- Heel pain in the morning
- Plantar fasciitis vs heel spurs
- Heel and ankle pain together
- Tarsal tunnel syndrome
- Heel pain in both heels (inflammatory)
- Heel pain after running
- Heel pain in pregnancy
- Bruised heel: stone bruise or bone bruise
- Insertional Achilles tendonitis
- Achilles tendon rupture: the signs
- Cracked heels
- Plantar fasciitis so bad you can’t walk
- When to worry about heel pain
Treat it
- The treatment ladder
- Heel spur treatment, step by step
- Why removing a spur is rarely the answer
- Stretches and exercises (printable sheet)
- How to tape your foot: KT and low-Dye
- Plantar fasciitis massage
- Achilles exercises (printable sheet)
- KT tape for Achilles tendonitis
- Cortisone shots: what they buy you
- Shockwave therapy: who it helps
- Laser therapy: what it can do
- PRP injections: who they help
- Night splints: who they help
- Walking boots: when one helps
- Plantar fasciitis surgery: who needs it
- When to stop reading and get examined
- How long plantar fasciitis lasts
- What one week of treatment can do
Kit it out
- Shoes, inserts and equipment
- Insoles and orthotics: prefab or custom
- All guides
- Best shoes for plantar fasciitis
- Shoes for heel pain, by cause
- Shoes for Achilles tendonitis
- Insoles for heel pain
- Heel cups: who they help
- Heel lifts for Achilles tendonitis
- Plantar fasciitis socks and sleeves
- Best running shoes for plantar fasciitis
- Best walking shoes for plantar fasciitis
- Best shoes for Achilles tendonitis
- Slippers for the first steps of the day
- Hoka vs Brooks for heel pain
- Best shoes for heel pain
- Best shoes for heel spurs
- Work shoes and boots for plantar fasciitis
- Sandals for plantar fasciitis
- Best heel cups
- Are Crocs good for plantar fasciitis?
- Are Birkenstocks good for plantar fasciitis?
In Michigan?
Dr. Biernacki treats heel pain in person at Balance Foot & Ankle in Howell and Bloomfield Township. Most heel pain is worked out in a single examination.
Heel Guide is education, not medical care, and it carries affiliate links. Read the editorial policy and the affiliate disclosure for exactly how that works.