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Fellows Podiatry Blog

Heel Pain

By March 27, 2023November 20th, 2023No Comments
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Heel pain is a complaint that is regularly seen in clinic but as always, taking a detailed patient history is important before any diagnosis as there are few differentials to take into consideration.

Differential diagnosis for heel pain

  1. Plantar Fasciitis – inflammation of the plantar fascia.
  2. Achilles Tendonitis – inflammation of the Achilles tendon.
  3. Heel Spur – bony protrusion from the anterior aspect of the heel bone.
  4. Sever’s – inflammation of the growth plate in the heel bone (usually in children)
  5. Stress Fracture – small cracks in the bone caused by repeated stress.
  6. Fat Pad Syndrome – reduced adipose fatty tissue over the heel bone
  7. Tarsal Tunnel Syndrome – compression/impingement of the posterior tibial nerve.
  8. Rheumatoid Arthritis – autoimmune disorder causing inflammation in the joints.
  9. Gout – build up of uric acid crystals in the joint causing inflammation.
  10. Nerve Entrapment – compression of the nerves in the foot.



The most common cause of heel pain is plantar fasciitis, which is an inflammation of the plantar fascia – the band of tissue that connects the heel to the toes. This inflammation can be caused by a variety of factors, including overuse, tightness in the calf muscles, poor footwear, or increased weight-bearing activities and increased BMI.

Another common cause of heel pain is heel spurs, which are small bony growths that can form on the heel bone. Heel spurs can be caused by excessive strain on the foot, such as taking part in physical activities like running, jumping or dancing. In some cases, they can also be caused either by flat feet or high arches.  Not all heel spurs are symptomatic and often they can be seen on x-ray but cause no pain.



Treatment options for heel pain depend on the underlying cause. For plantar fasciitis, conservative treatments like stretching exercises, strengthening intrinsic muscles, orthotics to support the foot movement, massage.  In some cases, non-steroidal anti-inflammatory drugs (NSAIDs) can also be prescribed to reduce pain and inflammation.

In cases where conservative treatment options have not been successful, shockwave therapy or corticosteroid injections may be considered. Both of these treatments are aimed at reducing inflammation around the plantar fascia and promote healing.

If heel spurs are the underlying cause of the pain, orthotics may be recommended to help redistribute pressure on the foot. In some cases, surgery may be necessary to remove the heel spur.

Wearing supportive footwear is very important and engaging in healthy lifestyle habits like maintaining a healthy weight and staying active. Having a more sedentary lifestyle may not actually be of benefit.  Taking good care of your feet and recognizing the early signs of heel pain can help you avoid complications.  Moving in a way that won’t aggravate the pain or end up with secondary pathology due to compensating for the heel pain.

If you are experiencing heel pain such as plantar fasciitis, or any other foot issues, I encourage you to make an appointment with me in Heswall, Wirral.  Joanna at Fellows Podiatry can help diagnose the underlying issue and develop a comprehensive treatment plan to get you back on your feet.

Heswall, Footworks, West Kirby, Wirral,  podiatrist, chiropodist, heel pain, plantar fasciitis.  Achilles tendon pain, foot pain, biomechanical assessment, gait analysis, foot scan, sidas medical insoles.  phits 3D printed orthotics, Podiatry Foot care, hard skin, corn removal, bunions, verruca treatment, Podiatry foot care treatment from a fully insured Podiatrist by the Royal College of Podiatry and standards checked by the Health Care Professional Council.