There are many sources of heel pain, but Plantar fasciitis is the most common condition that causes irritation of the arch and it often leads to other foot and heel conditions if not treated. The longitudinal arch which runs the length of the foot and the transverse arch which runs the width of the foot can become inflamed and they can cause the planter fascia tendon to tear or swell. Prolonged walking and standing causes irritation in the tendons and muscles of the foot. Heel spurs are commonly seen in patients who have long standing heel pain due to plantar fasciitis. Stress fractures should be considered especially in athletes such as long distance runners who have heel pain.

Symptoms of Tarsal Tunnel Syndrome

People who have problems with their arches are more susceptible to developing plantar fasciitis. The people genetically have either overly flat feet or high-arched feet. Poor footwear that does not provide proper support of the ankle and arches can also lead foot pain. People with flat feet or falling arches are also prone to Tarsal tunnel syndrome which is similar to carpal tunne sydrome where compression of the large nerve in the back of the foot (posterior tibial nerve) becomes entrapped or pinched. The pinched nerve may cause numbness and tingling or burning sensations in and around the heel and ankle area. It is important to seek treatment for these symptoms in order to prevent permanent nerve damage. In some cases, a minor procedure or surgery may be required to remove the mass that has increased pressure on the posterior tibial nerve. Varicose veins, swollen tendons, bone spurs and cysts could all be sources of the nerve compression.

Foot injury and Orthotic shoes

Athletes and overweight people tend to be more susceptible to foot injuries and sprained ankles.
Stress fractures of the Heel Bone (calcaneous) are an uncommon cause of heel pain, but when the calcaneus is fractured the movement of the large joint in the ankle (inversion and eversion) is commonly decreased or lost completely. In addition, heel bone fractures can lead to irregularity of the subtalar joint which causes arthritis and tendonitis and nerve damage to the heel pad. In most cases, patients are advised to reduce their activity levels and lose weight. Orthotic devices such as braces or custom shoe inserts can provide additional support to the arches and may also be recommended to help alleviate symptoms.


Posterior heel pain causes symptoms behind the foot, rather than underneath. Posterior heel pain causes include Achilles tendonitis and retrocalcaneal bursitis. Retrocalcaneal bursitis is a condition that causes swelling and tenderness of the heel. Pain usually gets worse while wearing shoes and during activity and long periods of standing or walking. Achilles tendonitis starts with a series of very small tears (microtears) in the connective tissue in or around the Achilles tendon. Both conditions improve with rest and proper stretches being incorporated into fitness routine, but months of rest may be required in more severe cases to reduce the risk of tendon rupture.