Causes of Heel Pain ?

What is Heel Pain in this content? What Causes Heel Pain? How does heel pain pass? How to Treat Heel Pain? What Is Good For Heel Pain? What are the Ex
Why Does My Heel Hurt ? 

What is Heel Pain in this content? What Causes Heel Pain? How does heel pain pass? How to Treat Heel Pain? What Is Good For Heel Pain? What are the Exercises for Heel Pain? You can find answers to questions such as: Please continue reading...

Heel pain (medical: tarsalgia) can have different causes. For example, many runners experience heel pain as a result of overuse. Bone spurs (heel spurs), broken bones, and rheumatic diseases can also trigger heel pain. Here you can read everything you need to know about possible causes and treatments for heel pain, and learn tips and exercises to help control heel pain.

Quick and Overview

Causes: tendonitis of the sole of the foot (plantar fasciitis or plantar fasciitis), heel spurs, pathological changes in the Achilles tendon, bursitis, broken bones, Bechterew's disease, S1 syndrome, tarsal tunnel syndrome, congenital fusion of the heel and scaphoid bones

When should you go to the doctor? If heel pain lasts longer, increases with exertion, limits walking, or is accompanied by other symptoms such as joint swelling.

Diagnosis: Doctor-patient interview (anamnesis), physical examination, X-ray (eg if a bone fracture is suspected), magnetic resonance imaging (eg if Achilles tendon changes are suspected), electromyography and electroneurography (if tarsal tunnel syndrome is suspected).

Treatment: depending on the cause, eg heel spurs, special shoe inserts, pain relievers, physical therapy and surgery if necessary. If there is no underlying disease: Recommendations and exercises against heel pain.

Tips and exercises: Avoid being overweight, get your feet straight, avoid excessive sitting, avoid tight shoes, warm up before sports, exercise in moderation, elevate your feet in case of acute pain (e.g. when running), cool down and take it easy.

Heel pain: causes

Heel pain can have various causes. Here you can find out which ones are the most important.

Tendinitis of the sole of the foot (plantar fasciitis or plantar fasciitis)

Plantar fasciitis is an abrasion-related (degenerative) disease of the tendon plate attachment in the heel hump (heel bone hump). The tendon plate connects the heel hump to the ball of the foot and together they form the longitudinal arch of the foot. Plantar fasciitis causes pressure pain in the heel.

This pressure pain initially only occurs when the foot is loaded, that is, when stepped on. However, after getting out of bed and resting later in the morning, heel pain may also occur on the back of the foot. The pain sometimes becomes so severe that those affected can no longer walk. It is also typical for this heel pain that it increases the day after the heel is loaded.

Heel pain that occurs as a result of plantar fasciitis is usually caused by physical activities such as running or jumping. However, the disease can also occur as a result of natural age-related wear and tear.

Heel Spur

Pain in the heel can also indicate a heel spur. This is a spur-like bony growth on the heel bone, but it doesn't necessarily hurt.

Depending on the location, doctors distinguish between a lower (plantar) and upper (posterior) heel spur.

The lower (plantar) heel spur (calcaneus spur) arises on the underside of the heel hump, where the short muscles of the foot and the tendon plate of the sole of the foot begin. It triggers severe pressure pain at the lower middle end of the heel bone. If the foot is loaded, there is a stinging pain on the sole of the foot. In extreme cases, those affected may only step on their front legs.

Upper (posterior) heel spur (Haglund exostosis, Haglund heel) is less common. It develops at the insertion of the Achilles tendon. Affected individuals experience pressure and pain when they walk or stand in sturdy shoes. Additionally, insertion of the Achilles tendon can hurt.

Pathological changes in the Achilles tendon

If the area of ​​the upper heel hurts, then there are often pathological changes in the Achilles tendon behind it. The Achilles tendon is the strongest tendon in the human body. It attaches the calf muscle to the heel bone. If the Achilles tendon attachment site on the heel bone becomes calcified, local swelling may occur with pressure pain. These symptoms can also occur when the Achilles tendon attachment is overstretched or inflamed.


There are two bursae at the junction of the Achilles tendon and the heel bone. Heel pain often occurs when they become inflamed.

One of the bursa is located between the Achilles tendon and the heel bone (Bursa subachillaea). For example, the upper heel spur can become inflamed due to overuse or certain diseases such as gout.

The second bursa (bursa postachillaea) is located between the Achilles tendon and the skin. It can become inflamed if you wear shoes that don't fit properly, squeeze or rub against your feet.


A broken bone in the heel area, such as a broken heel bone, can also cause heel pain. Most fractures are accidental. But there are also what are called fatigue fractures (stress fractures). For example, they can occur in overloaded bones in professional runners. The shinbone, metatarsal, and heel are particularly frequently affected. In the second case, heel pain occurs.

Bechterew's disease (ankylosing spondylitis)

Bechterew's disease is a chronic, inflammatory, rheumatic disease. It can lead to progressive ossification and hardening of the spine. Other joints and organs may also be affected.

Common symptoms of Bechterew's disease are, for example, rheumatoid arthritis, morning stiffness, and variable hip pain. Mobility of the lumbar spine is often limited and pain radiates to the thighs, often even the heels.

S1 syndrome

A pinched nerve in the spine can hide behind heel pain. In the so-called S1 syndrome, the nerve root exiting the spinal cord narrows in the first sacral vertebra. The cause of the narrowing may be, for example, a local herniated disc. The result is unilateral pain that extends from the hip down to the back of the thigh and lower leg, radiating from the heel to the outer edge of the foot (including toes three to five).

Why Does My Heel Hurt ? Why Does My Heel Hurt ?


Tarsal Tunnel Syndrome

Here, too, a nerve, namely the tibial nerve in the tarsal canal, is compressed. This is a kind of tunnel formed by the ankle bone, heel bone and inner malleolus, as well as a band-like structure as a "roof". Symptoms of tarsal tunnel syndrome include tingling, burning, and discomfort on the entire sole of the foot, the flexor tendons of the toes, or just the heel. Heel pain may radiate to the calf. There is also intense pressing pain behind the inner ankle.

Another symptom of tarsal tunnel syndrome: the soles of the feet produce much less sweat than usual.

Fusion of heel and navicular bone (coalitio calcaneonaviculare)

When the heel and navicular bones are fused congenitally, the movement of the ankle and Chopart joint (tarsal joint) is restricted. The first symptoms usually appear at school age: prolonged standing and walking leads to chronic foot pain (including heel pain). In addition, the ankles stiffen as they move.

Diseases with this symptom

  • Learn more about diseases in which the symptom can occur here:
  • heel spur
  • Tarsal Tunnel Syndrome
  • Fibroma
  • flat sole

Heel pain: tips and exercises

Are you already suffering from heel pain or want to prevent heel pain effectively? Then the following tips and exercises can help you.

If you have had heel pain for a long time, you should always consult a doctor (family doctor or orthopedist) to clarify the causes of your symptoms. You can then follow the tips and exercises prescribed by the doctor in addition to medical treatment.

Tips against heel pain

You can often effectively relieve and prevent heel pain if you follow these tips:

Avoid being overweight: Every extra kilo puts strain on the feet and encourages heel spurs and other foot problems. So make sure you have a healthy body weight. If you are overweight, you should try to lose weight.

Get your feet straight: Misalignments like flat feet can cause heel spurs and therefore trigger heel pain. For this reason, you should have foot deformities treated.

Avoid excessive sitting

Avoid tight shoes

Warm up before exercise: Warm up your muscles, tendons and ligaments before exercise. Otherwise, among other things, the Achilles tendon can quickly become overloaded. Inflammation with heel pain is often the result.

Exercise Moderately: Don't overdo it with exercise. In this way, painful fatigue fractures, for example in the heel, can be avoided.

Take first aid measures: In case of acute heel pain, you should elevate, cool and rest the affected foot.

Basically, you should always take heel pain seriously. If you have heel pain, do not exercise or stop exercising. Elevating, cooling, and resting the affected foot helps against acute pain.

Exercises for heel pain

Experts recommend regular calf training to prevent heel pain or relieve acute discomfort. For example, you can do the following stretching exercises every day:

Exercise against heel pain 1

Stand slightly in front of a wall and lean against the wall with your palms (arms almost fully extended). Place the leg with the heel pain slightly further back so that the knee is straight but the sole of the foot is on the ground. The other leg is in front with the knee slightly bent. It is important that the toes of both feet are facing the wall. Now lean forward slightly (i.e. bend your elbows) to increase the tension in the calf and the arch of the affected (back) leg. Make sure the sole of your foot is on the ground (don't lift your heel!). Hold this position for about 10 seconds. Then bring yourself back to the upright position. Repeat the exercise 20 times.

Why Does My Heel Hurt ? Why Does My Heel Hurt ?


Exercise against heel pain 2

Stand on a step with your toes pointing back and hold the handrail with one hand. Now slowly push your heels down as far as you can. Hold the position for 10 seconds and repeat the exercise 20 times.

Both exercises are great for your pre-workout warm-up.

Heel pain: description and forms

Heel pain is pain that occurs when resting or straining yourself. Affected people often feel pain when pressing on the back of the foot.

Depending on the location of the pain, a distinction is made between:

Lower or Plantar Heel Pain: This is pain under the heel. These are usually caused by inflammation of the tendon plate (plantar fasciitis) or a lower heel spur.

upper or dorsal heel pain: This is where the Achilles tendon attachment hurts. This heel pain usually occurs when the attachment point of the Achilles tendon is overloaded or inflamed, or when there is an upper heel spur.

Heel pain: when should you see a doctor?

A doctor's visit is indicated when:

  • long-term heel pain
  • Heel pain that increases with exertion
  • Heel pain that limits walking
  • Heel pain accompanied by other symptoms such as joint swelling

Heel pain: what does the doctor do?

The doctor first collects your medical history (anamnesis). He will ask you about your heel pain in detail. For example, it matters how long your heel has been hurting, exactly where it hurts, and whether you have other complaints, such as the back of your leg.

In conjunction with the history, various examinations can help determine the cause of heel pain. The most important research includes:

Physical examination: Here, the doctor tests for pressure pain or bone swelling in the heel area, which may indicate the heel spur, for example. It also checks, among other things, how flexible your joints are, how strong your muscles are, and whether you can walk normally.

X-ray examination: X-ray images make visible, for example, broken bones, heel spurs, and fusion of the heel and scaphoid bones. If Bechterew's disease is suspected, an X-ray examination can also provide certainty.

Magnetic resonance imaging (magnetic resonance imaging, MRI): If the doctor suspects pathological changes in the Achilles tendon behind the heel pain, they may use magnetic resonance imaging to investigate this suspicion. Bechterew's disease can also be detected with magnetic resonance imaging.

Electromyography (EMG) and electroneurography (ENG): If tarsal tunnel syndrome is suspected as the cause, the doctor may measure the electrical activity of muscles and nerves using an EMG or ENG.

Heel pain: treatment

If an underlying condition, such as a heel spur, or an injury (such as a broken bone) is causing heel pain, it needs to be treated. For example, if you have a heel spur, your doctor may recommend special insoles for your shoes or prescribe physical therapy (for example, shock wave therapy) and pain medications. A heel spur is usually only operated on if heel pain persists despite these conservative treatment measures.

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