What It Means If You Have Heel Pain When Walking
Find out the three most common causes of heel pain, plus how to treat it.
Do you feel a nagging pain in your heels while walking? You’re not alone. Though the exact prevalence of foot pain is hard to pinpoint due to the wide range of pain types and intensity, experts agree it affects more than one in 10 people worldwide.
A research review published in 2019 in Arthritis Care & Research suggests anywhere from 13 percent to 36 percent of the population experiences foot pain at some point in life. Of course, the foot consists of many parts—toes, arch, heel, and more. But three types of heel pain make up most of foot pain complaints, according to Christopher Kidd, MD, foot and ankle orthopedic surgeon at Cedars-Sinai Kerlan-Jobe Institute and team physician for the LA Galaxy Major League Soccer team.
Keep reading to learn more about why you might experience heel pain when walking, common at-home treatments for heel pain, and when to call a doctor for medical treatment.
(Related: 14 Benefits of Walking for Just 15 Minutes)
The three most common causes of heel pain
Plantar fasciitis is the first thing that comes to mind when a patient mentions heel pain, Dr. Kidd says. “Other things we consider: bursitis, which is pain around the backside of the heel, and tendonitis,” he adds. These three conditions make up about 75 percent of the heel pain cases he addresses.
What is plantar fasciitis?
Imagine a rubber band stretched from your toes to your heel. The rubber band supports the structure of your arch when you walk and absorbs shock when you jump or stomp your feet. That rubber band is like your plantar fascia—a long, thin ligament under your foot that keeps your heel and toes connected.
Plantar fasciitis occurs when the ligament becomes strained, inflamed, and irritated, according to the American Academy of Orthopaedic Surgeons (AAOS). You might get plantar fasciitis from overuse, or even from ill-fitting shoes.
What is bursitis?
The back of your heel bone is cushioned by fluid-filled sacs called bursas. Bursitis is the swelling and inflammation of a bursa. Bursitis might feel like a warm, painful ache at the back of your heel. Tight shoes usually make the pain worse.
What is tendonitis?
Achilles tendonitis involves irritation and inflammation of the large tendon that runs from your calf muscle to your heel bone. Like plantar fasciitis, this condition tends to crop up because of overuse, according to the AAOS.
Other possible causes of heel pain
Most heel pain is because of the three conditions above. But Dr. Kidd says if your pain does not respond to treatment after several weeks, your doctor might examine you for other causes of heel pain:
- stress fracture
- heel spur
- arthritis in the nearby ankle joint
(Related: Is Walking Barefoot Bad For Your Feet?)
How to pinpoint the cause of your heel pain
If you can’t put weight on your heel, see a doctor who can determine the cause of your pain. Excruciating pain that keeps you from walking at all could indicate a fracture or more serious condition, says Dr. Kidd. If you’re trying to identify foot problems yourself, Dr. Kidd says to pay attention to the location of the pain. Plantar fasciitis causes pain on the underside of your heel; bursitis causes pain toward the back of the heel; tendonitis tends to cause pain just above the heel.
Next, Dr. Kidd says to consider whether movement exacerbates or soothes your symptoms. Tendonitis and bursitis pain will likely worsen with activity, while plantar fasciitis might rise and fall throughout the day. “With plantar fasciitis, you’ll feel pain first thing in the morning, notice it improves after warming up, then feel it worsen after you’ve been on your feet for a while,” he says.
At-home treatment for heel pain
There are several ways to soothe your heel pain at home, according to Theresa Marko, PT, DPT, OCS a board-certified orthopedic physical therapist and certified early intervention specialist in New York. Most of these techniques work for plantar fasciitis, bursitis, and tendonitis. If any at-home treatment or remedy causes additional pain, however, stop immediately.
Resting your feet can help alleviate mild heel pain, particularly if the irritation is due to overuse. For best results, take the weight off your feet while also cooling them with an ice pack or a frozen bottle of water underfoot. Marko says there’s no need to elevate your feet—simply giving them a break from walking or standing will help.
If your heel pain is from tendonitis, Dr. Kidd recommends immobilizing the area with a soft brace from your local drugstore. He also says tendonitis rarely resolves without professional physical therapy.
Achilles stretches and calf stretches could help relieve tension around your heel. Marko’s favorite stretch for heel pain involves raising your toes onto a book or slant board, then leaning forward until you feel an intense stretch in your upper calf.
“Some people prefer hanging their heels off the edge of a step to get a slow, prolonged stretch,” she says. If you’re dealing with heel pain from plantar fasciitis, try these stretches.
If massaging your foot and calf brings relief, Marko says to go for it. Pain around your heel “ties into the calf muscle, which is tight,” she says. Massaging the bottom of your calf, right where it meets your heel, can help release that tension and relieve your pain. Some people also recommend acupuncture for issues like plantar fasciitis.
Over-the-counter anti-inflammatory medication
Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin, ibuprofen, and naproxen. These over-the-counter painkillers can be effective for short-term relief. Dr. Kidd warns they should be used in conjunction with stretching and mechanical therapy, however, to avoid simply masking your symptoms.
When to see a doctor about heel pain
According to Dr. Kidd, there are two situations in which you should see your doctor about heel pain while walking:
- Pain intensity. You feel sharp pain with every step.
- Pain persistence. “All of those problems will respond to treatment at least partially within three to four weeks,” Dr. Kidd says.
If your pain has persisted to the point that you’ve taken over-the-counter painkillers for more than a couple of weeks, it’s time to talk to a doctor. It’s also important to call your doctor if the prescribed treatment does not relieve your pain even after several weeks. “If it’s not getting better, I would recommend seeing a doctor or physical therapist … who is trained in assessing and identifying dysfunction in your joints and muscles,” Marko says.
In the end, a correct diagnosis for your heel pain is essential to feeling better quickly.