How Can I Relieve the Pain in My Heel?

For many causes of pain in the heel, the RICE method may be used:

• Rest and stay off your feet as much as possible
• Ice the affected area
  • Use a cold pack or ice wrapped in a towel
  • Ice 20 minutes at a time, several times a day
• Compression with a compression bandage or stocking
• Elevate the affected foot

Over-the-counter (OTC) pain relievers, such as acetaminophen (Tylenol), aspirin, and nonsteroidal anti-inflammatory drugs including ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn) may also be used for pain in the heel.

There are many different causes of pain in the heel and treatment to relieve pain depends on the cause. 

• Plantar fasciitis
  • Pain is felt beneath the heel and sole of the foot
  • Results from strain on a ligament that extends from the heel bone and fans out along the bottom of the foot to the toes
  • The fascia provides support to the arch of the foot and acts as a shock absorber
  • Caused by repetitive impact to the heel and plantar fascia by activities such as running, jumping, dancing, and standing for long periods 
  • Treatment to relieve heel pain from plantar fasciitis may involve: 
    • Stretching
    • Tape support 
    • Protective footwear
    • Shoe inserts
    • Walking cast 
    • Steroid injections for pain, though the effects usually only last a few weeks
    • Shockwave therapy
    • Surgery (usually a last resort)
• Fractures/stress fractures
  • A break in a bone that can be caused by direct injury to the foot, twisting of the foot, and other conditions that make the bones weak such as osteoporosis and certain medications
  • A stress fracture is a type of overuse injury in which the repetitive stress of the foot striking the ground causes trauma
  • Often occurs in people who participate in sports such as running, tennis, gymnastics, and basketball
  • Treatment to relieve heel pain caused by fractures may include:  
    • Immobilization of the injured area 
      • Cast
      • Walking cast
      • Splint
      • Brace
      • Healing boot 
    • Stress fractures are treated with rest and shoe inserts or braces 
• Heel spurs
  • Bone growth on the heel bone that causes heel pain 
  • Treatment to relieve pain in the heel caused by heel spurs may include: 
    • Proper stretching before activity
    • Appropriate footwear or shoe inserts
    • Steroid injections
    • Surgery for severe, prolonged conditions
• Arthritis (inflammation of the joints)
  • Causes pain and stiffness in the small joints of the foot and ankle 
  • There are more than 100 forms of arthritis
  • Treatment to relieve pain in the heel due to arthritis may include: 
    • Minimize or avoid activities that cause or worsen pain
    • Low-impact exercises such as swimming or cycling are preferred over high impact activities such as running
    • Physical therapy
    • Lose weight if overweight
    • Assistive devices such as braces, shoe inserts (orthotics), or custom-made shoes with stiff soles and rocker bottoms 
    • Steroid injections for pain (effects usually only last a few weeks)
    • Surgery, for cases that do not respond to non-surgical treatment
• Tarsal tunnel syndrome
  • Causes burning, aching, numbness, and tingling felt in the heel, the sole of the foot, and toes
  • The foot equivalent of “carpal tunnel syndrome” 
  • Results from compression of the tibial nerve in the region of the ankles 
  • Often caused by a fracture or dislocation involving the bones of the rear foot or ankle (talus, calcaneus, or medial malleolus)
  • Can also be caused by rheumatoid arthritis, other causes of inflammation, and tumors
  • Treatment for pain in the heel due to tarsal tunnel syndrome may include: 
    • Orthotics
    • Shoe modification
    • Corticosteroid injections 
    • Surgery to decompress the tibial nerve at the ankle for those unresponsive to conservative therapy
• Achilles tendon insertion and Haglund deformity
  • Frequently develops in distance runners and athletes involved in running and jumping sports, as well as people who do a lot of walking, hiking, or stair climbing
  • Treatment to relieve heel pain due to Achilles tendon insertion and Haglund deformity includes:
    • Concentric or eccentric exercises for Achilles problems
    • Icing
    • Heel lifts
    • Sports insoles and orthotics
    • Compressive straps
    • Topical nitroglycerin
    • Topical and oral nonsteroidal anti-inflammatory drugs (NSAID) 
    • Extracorporal shock wave lithotripsy
    • Surgery
• Acute Achilles tendinopathy
  • Sprinting, running hills, or excessive jumping may inflame the Achilles
  • Treatment to relieve heel pain due to acute Achilles tendinopathy includes:
    • Avoid aggravating activities
    • Ice
    • Short course of nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Support Achilles with a heel lift, elastic bandage, or taping
• Piezogenic pedal papules
  • Nodules caused by minor herniations of the fat pad through the capsule of connective tissue that surrounds the heel bone (calcaneus)
  • Treatment to relieve heel pain due to piezogenic pedal papules includes:
    • Restricting weight-bearing exercise
    • Weight loss
    • Compression stocking
    • Foam rubber foot pads or foam-fitting plastic heel cup
    • Corticosteroid injections
    • Surgical excision (rarely needed)
• Subtalar arthritis 
  • Can be caused by anatomic malalignment, leg-length inequality, and secondary arthritis from trauma following fractures
  • Treatment to relieve heel pain due to subtalar arthritis includes:
    • Limit standing and walking
    • Comfort shoes    
    • Ice and elevation after activity 
    • Weight loss    
    • Ankle brace    
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (Tylenol)
    • Corticosteroid injections
    • Hyaluronic acid injections 
    • Strengthening and stretching 
    • Surgery 
• Flexor hallucis tendinopathy 
  • Injury occurs during activities that entail excessive stress during toe-off, such as ballet dancing 
  • Treatment to relieve heel pain due to flexor hallucis tendinopathy includes:
    • Rest
    • Shoe orthotics
    • Soft tissue and joint mobilization
    • Surgical release of the flexor hallucis tendon 
• Heel contusion (also called heel pad or foot pad contusion)
  • Caused by acute trauma (e.g., landing from high fall), stepping on a root or rock during trail running, or chronic overuse (e.g., distance running in shoes with inadequate heel cushion)
  • Treatment to relieve heel pain due to heel contusion includes:
    • Rest
    • Ice
    • Cushioned orthotic
    • Support (including a heel pad and possibly taping)
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (Tylenol)
    • Non-weight bearing period if pain is severe