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Heel pain & plantar fasciitis
Dreading those first steps out of bed, or feeling heel pain again after sitting? Plantar fasciitis, tendon problems and other conditions can cause heel pain. We’ll listen to the pattern and assess what may be contributing.
On this page
How we assess and manage heel pain
- We listen to when the pain started, where you feel it, what brings it on and how it affects walking, work, exercise or daily life.
- We examine the heel and surrounding areas and may look at your walking, movement, footwear, strength and recent changes in activity.
- We explain the likely cause, what remains uncertain and whether imaging, medical review or another referral may be appropriate.
- Together, we agree on a manageable plan. This may include adjusting activity or routines, footwear advice and strength and lower-limb rehabilitation. Hands-on care, shockwave therapy or orthotics may be considered when the assessment suggests they could add value.
Heel pain after rest or on your first steps?
Our guide explains why heel pain can feel worse after rest. This page stays focused on assessment and deciding what to do next.
Other causes your podiatrist may consider
Heel pain is not always plantar fasciitis. The location and pattern can point towards different possibilities:
- Under the heel — symptoms may relate to the plantar fascia, the heel’s cushioning fat pad or, less commonly, a stress injury.
- At the back of the heel — the Achilles tendon or where it attaches to the heel may be involved.
- Burning, tingling or pins and needles — this can suggest irritation of a nerve rather than a typical plantar heel-pain pattern.
- In an active child — heel pain may involve the growth plate (Sever’s disease) and needs a different assessment.
These patterns can overlap. Assessment helps narrow down the likely cause and whether further investigation is needed.
What may influence symptoms: a recent increase in walking or running, long periods on hard surfaces, footwear, work demands, calf capacity and how load is distributed through the foot. Foot shape, including flat feet or high arches, may be one part of the picture rather than the diagnosis itself.
Consider an assessment if the pain is persisting, worsening, changing how you walk, or limiting work, exercise or everyday activities.
References
- Nahin RL. Prevalence and pharmaceutical treatment of plantar fasciitis in United States adults. J Pain 2018;19(8):885–896. doi
- Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: a matched case-control study. J Bone Joint Surg Am 2003;85(5):872–877. doi
- Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc 2003;93(3):234–237. doi
- Koc TA Jr, Bise CG, Neville C, et al. Heel pain–plantar fasciitis: revision 2023. J Orthop Sports Phys Ther 2023;53(12):CPG1–CPG39. doi
- DiGiovanni BF, Nawoczenski DA, Malay DP, et al. Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. J Bone Joint Surg Am 2006;88(8):1775–1781. doi
- Hansen L, Krogh TP, Ellingsen T, Bolvig L, Fredberg U. Long-term prognosis of plantar fasciitis: a 5- to 15-year follow-up study of 174 patients. Orthop J Sports Med 2018;6(3):2325967118757983. doi