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5 Major Causes of Heel Pain

Heel pain is a common foot problem with several common causes. It is important to make an accurate diagnosis of the cause of pain symptoms, so that appropriate treatment can be directed at the cause of heel pain.

Doctor can usually determine the cause of heel pain based on the symptoms and a physical exam.

5 Major Causes of Heel Pain & Its Treatment

5 Major Causes of Heel Pain are:

  1. Heel Pain Caused Due to Baxter’s Nerve Compression

    Heel Pain Due To Baxter's Nerve Compression

    Baxter’s nerve is a nerve branch which runs beneath the heel bone. It may become entrapped in the medial heel. Baxter’s nerve entrapment may cause heel pain, paresthesias, abnormal sensation on the plantar aspect (bottom) of the heel, and medial heel tenderness.

    The abductor hallucis muscle of sprinters, dancer and gymnasts are well developed and it causes Baxter’s nerve compression when the athletes are frequently on their toes.

    Treatment for Heel Pain Caused Due to Baxter’s Nerve Compression Includes:

    • NSAIDs
    • Heel stretching exercises.
    • Orthoses.
    • Surgery to decompress Baxter’s nerve at the fascia between the quadratus and abductor hallucis.
  2. Heel Pain Caused Due to Plantar Fasciitis

    Heel Pain Due To Plantar Fasciitis

    Plantar fasciitis is a medical condition in which there is inflammation and swelling of thick tissue on the bottom of foot leading to heel pain. This thick tissue is called the plantar fascia. This can be painful, making walking more difficult. Plantar fasciitis gets usually worse in mornings when the patient takes the first stand on the feet.

    Walking and stretching exercise often give relief from this painful tightening associated with plantar fasciitis. Prolonged exercise or standing makes the heel pain symptoms more intense. Clinical feature also includes medial calcaneal tuberosity tenderness and tight heel cord.

    Treatment for Heel Pain Caused Due to Plantar Fasciitis Includes:

    • Anti-inflammatory medications
    • Heel stretching exercises
    • Shoe inserts (heel padding)
    • Rarely surgery
  3. Heel Pain Caused Due to Fat Pad Atrophy

    Heel Pain Due To Fat Pad Atrophy

    Fat pad atrophy is a condition that can develop in the ball of the foot. In fat pad atrophy the fat that cushions the calcaneus is diminished.

    The symptom of fat pad atrophy includes experiencing pain in the ball of the foot. It can give significant heel pain while walking. This condition is quite common in the elderly population. Heel pain caused due to fat pad atrophy can be treated through a variety of methods; there is also a history of injecting steroids to a lot of patients.

    Treatment for Heel Pain Caused Due to Fat Pad Atrophy Includes:

    • Anti-inflammatory medications
    • Shoe inserts (custom orthotics)
  4. Heel Pain Caused Due to Achilles Tendonitis

    Heel Pain Due To Achilles Tendonitis

    It is a common condition that causes chronic pain to the tendon connecting heel to muscles of lower leg. It primarily occurs from overuse of the tendon. This tendon is called the Achilles tendon. It gives the ability to rise up on toes, allowing for the act of walking.

    Achilles tendonitis makes walking quite painful and trouble standing on one toe.

    Treatment for Heel Pain Caused Due to Achilles Tendonitis Includes:

  5. Heel Pain Caused Due to Calcaneal Stress Fracture

    Heel Pain Due To Calcaneal Stress Fracture

    Due to overuse, a stress fracture can occur in the calcaneus bone. Calcaneal stress fracture can also occur from a sudden force to the heel. Symptoms of calcaneal stress fracture include weight bearing pain.

    Stress fracture injuries of the heel are common for running sports due to the repetitive shock being placed on the heel. A calcaneal stress fracture causes pain by side to side compression of the calcaneus.

    Treatment for Calcaneal Stress Fracture Includes:

    • Rest
    • Partial to complete immobilization
    • Activity modification.


  1. American Academy of Orthopaedic Surgeons. (2014). Heel Pain. OrthoInfo https://orthoinfo.aaos.org/en/diseases–conditions/heel-pain
  2. Mayo Clinic. (2021). Plantar Fasciitis https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846
  3. American Academy of Orthopaedic Surgeons. (2019). Achilles Tendinitis. OrthoInfo https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis

Also Read:

Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 11, 2023

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