“I didn’t do anything to it” is how most heel pain starts. Tissues tolerate a rising load quietly until one day they do not, and the first you know about it is a heel that hurts on the way to the bathroom. This page covers the usual causes of sudden heel pain, three quick checks you can do yourself, and the signs that mean it should be seen today rather than stretched.

Why heel pain can start suddenly

The plantar fascia, the Achilles and the heel bone all adapt to the load you put through them, but slowly. When load rises faster than they can adapt, damage builds without symptoms for a while, and then a threshold is crossed. The trigger is often something small that tips an already overloaded tissue over the edge. Look back over the last few weeks for:

• New shoes, worn-out shoes, or a switch to flat sandals or barefoot at home.
• A jump in walking, running, standing time or a new job on hard floors.
• A holiday with long days of sightseeing, or a house move.
• Weight gain, including during pregnancy.
• Recent time off your feet, followed by a quick return to normal.

If one of those fits and the pain behaves like the first row of the table below, it is very likely an ordinary flare, and it is safe to start treating it at home.

Causes of sudden heel pain

Where the pain is also matters. For pain at the back of the heel rather than underneath, see back of heel pain.

Three checks you can do now

1. The squeeze test. Cup the heel bone and squeeze it firmly from both sides, below the Achilles. Pain from that squeeze is a warning sign of a stress fracture. Plantar fasciitis usually does not hurt with it.
2. The tiptoe test. Holding onto something, rise up onto the toes of the painful foot alone. Being completely unable to, especially after a pop, suggests an Achilles rupture.
3. Look and feel. Compare both heels. Swelling, bruising, redness, warmth, or a wound on the bad side are all reasons to get it seen rather than wait.

When it cannot wait

The full list, sorted by urgency, is on when to worry about heel pain.

What to do in the first few days

If none of the warning signs apply and the pain behaves like a plantar fasciitis flare, these are safe to start straight away:

1. Cut the load, do not stop moving. Shorter walks, fewer hours standing still on hard floors, and no running or jumping for now.
2. Supportive shoes from your first step, including indoors. Barefoot on tile or wood is the hardest thing a sore heel does all day.
3. Stretch before you stand. Pull the toes and ankle back for ten seconds, ten times, sitting on the edge of the bed.
4. Ice or a frozen bottle under the arch for ten minutes after a long day.
5. Watch the trend. A flare should be settling within a week or two. If it is getting worse, or the pattern changes, get it assessed.

After that, the plantar fasciitis treatment page sets out the full plan.

Common questions

What causes sudden heel pain without injury?

Most often a flare of plantar fasciitis, where the fascia has been overloaded for weeks without symptoms and finally objects. Less common causes are a heel stress fracture, a partial tear of the fascia, an Achilles rupture, a bruised fat pad, nerve irritation, gout or inflammatory arthritis, and infection. The pattern of the pain, and a few simple checks, usually tell them apart.

Why does my heel suddenly hurt when I walk?

Walking loads the heel with every step, so any irritated tissue there will complain. If it is worst on the first steps after rest and then eases, the fascia is the likely cause. If it gets worse the longer you walk, or squeezing the heel hurts, a stress fracture needs ruling out.

Can plantar fasciitis come on suddenly?

Yes, it often seems to. The tissue changes build up over weeks or months, but the pain tends to appear quite abruptly, frequently after a change in shoes, activity or time on your feet.

What causes sudden severe heel pain?

Severe pain that stops you walking deserves a same-day look, because it can be a fracture, a tear, a rupture or an infection. A bad plantar fasciitis flare can also be severe, but it usually eases after the first few steps and is not hot, swollen or bruised.

Should I go to urgent care for heel pain?

Go the same day if you cannot bear weight, heard or felt a pop, cannot rise onto tiptoe, have a hot, red, swollen heel or fever, have a wound or puncture on the heel, or have diabetes with any new wound or swelling. Otherwise, a routine appointment is fine if the pain is not settling after a week or two.

How do I know if my heel is fractured?

A stress fracture usually builds with activity, aches deep in the heel, and hurts when the heel bone is squeezed from both sides. A fracture from a fall or hard landing usually means you cannot put weight on the foot at all, often with swelling and bruising. Both need an examination, and early X-rays can look normal with a stress fracture, so an MRI is sometimes needed.

Related heel pain guides

• When to worry about heel pain — every warning sign, sorted by urgency.
• Heel stress fracture — the heel pain that gets worse the more you do.
• Plantar fasciitis — the most common cause, and how to recognise it.
• Back of heel pain — causes at the back of the heel, including Achilles rupture.
• Heel pain causes by location — working out what you have from where it hurts.

• Tu P. Heel Pain: Diagnosis and Management. American Family Physician, 2018.
• Allam AE, Chang KV. Plantar Heel Pain. StatPearls, NCBI Bookshelf.
• Buchanan BK, Sina RE, Kushner D. Plantar Fasciitis. StatPearls, NCBI Bookshelf.
• Bergman R, Kaiser K. Stress Reaction and Fractures. StatPearls, NCBI Bookshelf.
• Shamrock AG, Dreyer MA, Varacallo MA. Achilles Tendon Rupture. StatPearls, NCBI Bookshelf.
• American Academy of Orthopaedic Surgeons, OrthoInfo. Heel Pain.