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Heel pain & plantar fasciitis
Heel pain on your first steps or through a shift has more than one possible cause; plantar fasciitis is one of them.
Bracing for the first steps out of bed, or finding it hard to stand through a shift, walk with family or exercise? Which part of your day it affects helps guide the assessment.
On this page
What should I do now about heel pain?
Easing off activities that clearly aggravate the pain, wearing comfortable supportive shoes and gentle stretching, if it is comfortable, may help some people.
Consider an assessment if the pain is persisting through your working day, first steps are getting harder, it is changing how you walk, or it has not eased after two weeks of self-care. Before you come, note when it is worst and what changed recently—shoes, walking, running or time on your feet.
Already wearing orthotics that aren’t helping? See Still sore in your orthotics?
Warning signs that need same-day or emergency care are listed in when to seek urgent medical care, just below.
What might be causing your heel pain?
Heel pain after rest or on your first steps?
Plantar heel pain may ease with movement, then return after rest. This pattern doesn’t confirm plantar fasciitis, and heel pain can vary from week to week. Our guide explains why heel pain can feel worse after rest.
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. See why a child’s heel may hurt.
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.
What could happen at a heel pain appointment in Burwood?
What does a podiatrist do for heel pain and plantar fasciitis?
- We ask when and where it hurts and what brings it on, and examine the heel, walking, footwear, strength and recent changes in activity.
- We explain whether your pattern fits the plantar fascia, the heel’s fat pad, a tendon, an irritated nerve or, less commonly, a stress injury, how confident we can be, and whether imaging or medical review would add anything.
- 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.
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