Understanding Heel Pain: Causes, Symptoms & When to See a Podiatrist
Heel pain is one of the most common reasons Australians seek podiatry care — and it often strikes without warning. Whether the pain is sharp first thing in the morning, aching after long hours on your feet, or burning at the back of the heel, heel pain can significantly impact your mobility and quality of life.
At Podiatry Hub, we assess, diagnose, and treat heel pain every day. This guide explains why heel pain happens, the most common causes, and how early treatment can get you back on your feet faster.
Why Does Heel Pain Occur?
Heel pain is usually caused by inflammation or overload of the structures that support your foot. These include the plantar fascia, Achilles tendon, bursae, fat pad, nerves, and joints.
Most Common Causes of Heel Pain
- Plantar Fasciitis (Most Searched Condition)
Plantar fasciitis accounts for the majority of heel pain cases.
It occurs when the plantar fascia — a thick band of tissue under the foot — becomes irritated or overloaded.
Typical symptoms:
- Sharp, stabbing heel pain
- Pain on first steps in the morning
- Tight calves or arch discomfort
Common triggers include unsupportive footwear, high training loads, prolonged standing, or over-pronation.
- Achilles Tendinopathy
Pain at the back of the heel is commonly linked to the Achilles tendon.
This condition often affects active people, runners, or those whose footwear elevates the heel excessively.
Typical symptoms:
- Back-of-heel pain
- Stiffness in the morning
- Pain with walking uphill or running
- Heel Fat Pad Syndrome
The fat pad under the heel thins or becomes irritated, causing deep, bruised pain.
Typical symptoms:
- Pain directly under the heel
- Worse on hard surfaces
- Improves with cushioned footwear
- Heel Spurs
A heel spur is a calcium deposit that develops due to long-term strain.
Contrary to popular belief, heel spurs do not always cause pain. Pain usually comes from the soft tissues around the spur.
- Nerve-Related Heel Pain
Compressed nerves (e.g., Baxter’s nerve entrapment) can cause burning or tingling heel pain that mimics plantar fasciitis.
- Growth-Plate Pain in Children (Sever’s Disease)
A common cause of heel pain in active kids aged 8–14.
This occurs when the heel growth plate becomes irritated from sport or tight calf muscles.
Contributing Factors
- Unsupportive or worn-out footwear
- Sudden increases in activity
- Standing for long hours
- Hard surfaces
- Tight calf muscles
- Flat feet or high arches
- Weight changes
- Poor foot biomechanics
Understanding the cause is vital because each type of heel pain requires a different treatment approach.
How Podiatry Hub Diagnoses Heel Pain
Our podiatrists use:
- Clinical assessment & gait analysis
- Footwear evaluation
- Ultrasound referral when needed
- Biomechanical testing
A precise diagnosis ensures treatment is targeted and effective — not just temporary relief.
Treatment Options for Heel Pain
✔ Footwear Recommendations
Proper footwear is one of the quickest ways to relieve heel strain.
We review your shoes and guide you toward options that match your foot type and activity level.
✔ Custom or Prefabricated Orthotics
Orthotics reduce pressure on the plantar fascia or Achilles tendon and correct biomechanical overload.
✔ Manual Therapy & Exercise Programs
Stretching, strengthening, and mobility exercises are essential for long-term recovery.
✔ Load Management Plans
We adjust activities to allow healing without stopping movement entirely.
✔ Taping or Heel Cushions
Great for short-term symptom relief.
✔ Sports and Running Technique Advice
If your heel pain is exercise-related, technique adjustments can prevent recurrence.
When to See a Podiatrist
Book an assessment at Podiatry Hub if:
- Pain lasts more than 1–2 weeks
- Pain is sharp or worsening
- You struggle with first steps in the morning
- Heel pain limits walking, sport, or work
- You’re unsure what’s causing the pain
Early intervention leads to faster recovery and prevents chronic issues.
Heel Pain FAQs
Q1. Why does my heel hurt first thing in the morning?
This is a classic sign of plantar fasciitis. Overnight, the plantar fascia tightens; the first steps stretch it suddenly, causing pain.
Q2. Will heel pain go away on its own?
Sometimes, but not always. Without proper treatment, heel pain can last months or longer. Early podiatry care shortens recovery time significantly.
Q3. Are heel spurs the reason for my pain?
Not necessarily. Most heel spurs are painless. Pain usually comes from inflamed soft tissues such as the plantar fascia.
Q4. What shoes are best for heel pain?
Supportive shoes with firm heel counters, cushioned midsoles, and arch support help reduce strain. At Podiatry Hub, we provide personalised footwear advice.
Q5. Should I rest or keep moving when I have heel pain?
Rest helps temporarily, but complete rest can worsen stiffness. Guided load management is best — we’ll provide a tailored plan.
Q6. How do I know if I have Achilles tendinopathy instead of plantar fasciitis?
Achilles pain is usually at the back of the heel, while plantar fasciitis pain is under the bottom of the heel. A podiatry assessment confirms the diagnosis.
Q7. When should my child with heel pain see a podiatrist?
If your child limps, avoids sport, or has persistent heel pain, assessment is recommended. Sever’s disease is common and very treatable.
Book Your Heel Pain Assessment at Podiatry Hub
Heel pain is treatable — you don’t have to live with it.
Our podiatrists will diagnose the exact cause of your pain and create a personalised treatment plan to get you back on your feet comfortably.
📅 Book an appointment today:
Book now!
Dylan McDonald (Podiatrist)