Heel pain - Causes 

Causes of heel pain 

Bone spurs

Bone spurs are an excess growth of bone that forms on a normal bone.

Bone spurs can develop on the heel (a heel spur) and are more common in people with heel pain. However, they can also occur in people without heel pain. 

A heel spur does not cause heel pain.

Plantar fasciitis is the most common cause of heel pain, accounting for around four out of five cases.

Plantar fasciitis is when the thick band of tissue that connects the heel bone with the rest of the foot (the plantar fascia) becomes damaged and thickened.

Damage to the plantar fascia is thought to occur following:

  • sudden damage – for example, damaging your heel while jogging, running or dancing; this type of damage usually affects younger people who are physically active
  • gradual wear and tear of the tissues that make up the plantar fascia – this usually affects adults who are 40 years of age or over

Increased risk

You are at an increased risk of gradual wear and tear damaging your plantar fasciitis if you:

  • are overweight or obese – if you have a body mass index (BMI) of 30 or over, you are considered to be obese  
  • have a job that involves spending long periods of time standing
  • wear flat-soled shoes – such as sandals or flip flops

Less common causes

Less common causes of heel pain are described below.

Stress fracture

A stress fracture can occur if your heel bone is damaged during an injury.

Fat pad atrophy

Fat pad atrophy is where the layer of fat that lies under the heel bone, known as the fat pad, starts to waste away due to too much strain being placed on the pad.

Women who wear high-heeled shoes for many years have an increased risk of developing fat pad atrophy.

Bursitis

Bursitis is inflammation of one or more bursa (small fluid-filled sacs under the skin, usually found over the joints and between tendons and bones).

It's possible to develop bursitis anywhere inside the body, not just in the foot.

Tarsal tunnel syndrome

The nerves in the sole of your foot pass through a small tunnel on the inside of the ankle joint, known as the tarsal tunnel. If a cyst forms or the tunnel is damaged, the nerves can become compressed (squashed). This can cause pain anywhere along the nerve, including beneath your heel.

Sever's disease

Sever's disease is a common cause of heel pain in children. It's caused by the muscles and tendons of the hamstrings and calves stretching and tightening in response to growth spurts.

The stretching of the calf muscle pulls on the Achilles tendon. This pulls on the growing area of bone at the back of the heel (growth plate), causing pain in the heel.

The pain is further aggravated by activities such as football and gymnastics. The pain often develops at the side of the heel, but can also be felt under the heel.

Calf and hamstring stretches and, if necessary, heel pads are usually effective treatments for Sever's disease.

Page last reviewed: 17/10/2012

Next review due: 17/10/2014

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The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Zuhair Bukhari said on 25 June 2011

Dear PVF,

Good Day,

Glad to know you are feeling better already, i have the same problem since 1 year and yes I am overweight too. Had no idea that not walking properly could be a reason, if you can please provide me the link to your research mentioned above, i'll be grateful to you.

Thanks

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PVF said on 10 March 2010



I suffered Plantar fasciitis in my left foot triggered by going for a long hike after an extended period of little exercise. The GP gave me pain killers and it got better at first then got steadily worse until I could barely walk. A cortisone injection and anti-inflammatory pills improved the pain for a month or two, but back it came again. I tried a podiatrist and a Physiotherapist (hoping for ultrasound treatment) but they had no solutions. All the pain killing had not found the underlying cause.
In desperation, I searched the internet and found a foot muscle and Achilles tendon stretching and strengthening regime which I followed for six months. It did the trick, if very slowly.
It seems that my Plantar fasciitis had been caused by my not walking properly; not using the foot muscles in the way they should and so putting all the strain of every step on the Plantar Fascia. My steadily increasing weight no doubt added to the strain.
In all of the NHS advice and the GP, no mention is made of this possible cause and hence solution.
I wonder if it could be investigated and integrated into the possible range of treatments offered.

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