Heel pain (plantar fasciitis): causes & pain relief

Our feet bear all our weight, every time we stand up, walk or run. So it isn’t surprising that occasionally they suffer aches and pains.

However, having pain in the heal of your feet can make even slow walking painful. This is because each step you take involves putting your heel down first, and jarring the part of your foot that already hurts.

What could be causing your heel pain?

Your shoes

Flip-flops can cause problems because they don’t usually provide support for your foot and they are often thin, too, meaning your heel endures more pressure with each step.

But shoes designed to support your foot and help with foot pain can also cause problems if you’ve chosen a shoe size (in terms of length or width) that doesn’t fit your foot properly. If a supportive shoe is too small, the support at the back of the heel will put excess pressure on the edge of your heel; if a supportive shoe is too big, your arch won’t be well supported and it may rub on your heel too.

Other shoes that can cause problems are flat shoes where the sole is too thin to provide any relief for your heel, and training shoes that are worn out and so aren’t protecting your heel any more. 

If you've lived in high heels throughout your life you might find that the heels have forced the leg, ankle and foot into unnatural positions, straining your muscles and tendons. They can also push your feet forward, which can squash toes leading to corns and bunions.

The solution? It’s probably best to get another pair of shoes that give you the full support you need.

Most injuries will heal after six to eight weeks if you rest properly – that means giving your heel the support it needs when you do have to walk and walking and running as little as possible so it has a chance to recover. 

If your feet ache when you wear flat shoes your calf muscles and Achilles tendon could have shortened. See a physio about calf stretching exercises. Wear supportive shoes such as trainers to help improve muscle function. A podiatrist will be able to advise on corns and bunions. Save high heels for special occasions and wear gel-based insoles to make feet more comfortable.

Related: Foot problems and how to treat them

Your foot's shape

If you’ve got a naturally low or high arch, your foot is unbalanced and so as you walk your feet may roll in, for example, putting extra pressure on one part of your heel.

Similarly, if you’ve worn high heels for a large proportion of your life, your feet are also more at risk of problems later. Walking in heels naturally causes you to put more of your body weight on your heels rather than the whole of your foot, and standing in heels forces the foot into an unnatural position putting excess strain on some parts of the foot too.  

The solution? Shoe inserts can make the world of difference to people who have naturally high or low arches, by providing support where you need it (the arch) which then helps prevent your foot from rolling inwards and putting extra pressure on one side of your heels.

You can also get heel inserts that help support your heel reducing pain. And those heels? Try to save them for special occasions only. 

An illness

Arthritis, infections and diabetes can all trigger heel pain.

Arthritis, for example, can cause pain and inflammation in any joint, including the heel.

Diabetes, which can cause damage to your nerves, can mean that you’re no longer able to feel your feet as well as you could. That can mean you walk more heavily, or even hit obstacles with your heel without realising. 

The solution? Treating the symptoms involves using heel supports and giving your body a chance to heal, but ideally you will treat the root cause – the illness itself.

So for arthritis, exercise such as swimming will help you build strong supportive muscles so that you can walk without putting so much pressure on the heel, for example.

Related: Lifestyle changes for osteoarthrits

An injury

Perhaps surprisingly, injuries to your heel aren’t usually the result of falling or hitting your heel, although that can happen, they’re more likely to be the result of stress or strain from repeated movements.

As your heel takes the brunt of force of your body weight as you walk or run, it’s under a lot of pressure. That means that most heel pain develops over time – you may not even realise you’re damaging your heel until you start to feel pain when injury has already occurred.

Plantar fasciitis, for example, can occur if you run or wear unsuitable (unsupportive) footwear. You may also develop a heal spur, which is a bony growth at the base of the heel bone. This occurs when the plantar fascia (a tendon) gets strained.

Inflammation can also occur in your heel pad, a result of the heel pad becoming too thin or wearing shoes that are flat with a thin sole. 

The solution? Ice or a cool pack on your heel will ease the pain and reduce swelling and inflammation too. You’ll need to rest your feet until the damage has been healed, which may take up to two months if you rest properly and protect your heel with shoe inserts when you do have to walk, taking care not to place all your bodyweight directly on your heel.

New footwear will help prevent the damage occurring again and you may want to adjust the way you walk or run. For example, you should try not to extend your leg too far forward from the other as this can cause you to come down on your heel with extra force. 

Unlimited access to a qualified GP with Saga Health Insurance - you'll have access 24 hours a day, 365 days a year to a GP consultation service. Find out more about our GP phone service.

What is plantar fasciitis?

Plantar fasciitis is the most common cause of heel pain, accounting for four out of five cases of painful heels. Plantar fasciitis happens when your plantar fascia, a strong, flexible band of tissue (similar to ligaments), becomes inflamed or damaged.

Your plantar fascia runs under your foot, stretching from your heel bone to the base of your toes. It acts rather like a shock absorber, as well as supporting the arch of your foot.

What causes plantar fasciitis?

You can damage your plantar fascia to the point where it hurts to walk, simply by using your feet.

Having to stand for long periods (at work, for instance) can cause this problem.

It can also happen as the result of years of walking and running, which can cause repeated small tears in your plantar fascia. This build-up of minor injuries can cause plantar fasciitis and cause you pain.

Other causes of damage can include starting to exercise on your feet – walking and running for instance - having done little of this before.

Being overweight or obese, and wearing shoes with little support for the arches under your feet can also cause this condition.

Whatever the cause, plantar fasciitis is fairly common, with about one in 10 people having this problem at some stage in their lives.

What are the symptoms of plantar fasciitis?

The symptoms of planta fasciitis includes pain under the heel, sometimes radiating to the front of the foot. The pain tends to be worst first thing in the morning. After a few minutes it eases as the foot gets warmed up, but can get worse again during the day, especially if walking a lot

Treatment for plantar fasciitis

If either of your heels is causing you pain, it’s probably a good idea to see your GP. They may suggest over-the-counter painkillers, and losing weight if you are overweight.

They may also refer you to a physiotherapist, who will probably suggest exercise to help ease the problem.

Other ways to ease the pain of plantar fasciitis include resting the affected foot as much as possible. Don’t stand up, walk or run for long periods of time. And choose your shoes carefully – go for laced-up shoes that give good support under the arches of your feet.

Shoes with a decent amount of padding at the heels should help protect that part of your foot. You can also buy inserts or insoles to fit into your shoes, to give extra protection. You can buy these from pharmacies, or you can make an appointment with a registered chiropodist or podiatrist (both titles mean the same) who are trained to care for feet. A chiropodist or podiatrist will be able to give you advice on the type of insole that will be best for your feet.

Ask your GP, health visitor or practice nurse if you can be referred to a chiropodist or podiatrist through the NHS. You may be able to have free treatment but this is likely to depend on how seriously your situation is affecting your health.

You may have to pay to see a chiropodist or podiatrist privately. Check to see what an appointment will cost in your area, before going ahead.

Stretches to help ease a sore heel

The stretching technique involves the patient sitting with one leg crossed over the other and stretching the arch of the foot by pulling back the toes for a count of 10.

The exercise must be repeated 10 times, and performed at least three times a day, including first thing in the morning and after prolonged periods of sitting.

According to the study published in the Journal of Bone and Joint Surgery, the US researchers found that three to six months after starting the exercise, sufferers had a 75 per cent chance of being pain-free. The majority needed no further treatment.

Subscribe today for just £34.95 for 12 issues...

Subscribe today and save 51%