Heel pain is common and can make walking awkward. The most common cause is irritation of the plantar fascia, the strong band of tissue that supports the arch of the foot. The pain is often worst with the first steps in the morning and improves once the foot warms up.
Home care is based on stretching, support under the heel and reducing the load for a while. Most cases improve without surgery, but recovery can take patience.
Plantar fascia irritation#
The plantar fascia runs from the heel to the toes and supports the foot arch. When it is overloaded, the attachment at the heel can become painful. Standing work, sudden increases in exercise, high body weight and poor footwear are common triggers. Tight calf muscles also increase the load.
The pain is usually sharp and felt under the heel. It is often worst after rest and may ease as you walk, but it can return after long standing or long walks. Many people notice the first steps out of bed are the most painful.
Other causes of heel pain#
Pain at the back of the heel more often points to the Achilles tendon attachment area, especially if it hurts when rising on the toes or running. A thin heel pad can also cause pain under the heel, especially on hard floors. If the heel is swollen and warm without a clear overload trigger, the cause may be something else that needs assessment.
What to try at home#
Stretching is the mainstay of care. Gentle calf stretches and plantar fascia stretches several times a day can reduce strain. A simple calf stretch is done against a wall with the back leg straight and the heel on the floor. Hold it calmly for about half a minute and repeat a few times.
A heel pad or gel insert can soften impact and make walking less painful. Supportive, well-fitting shoes matter more than one special insole. Very flat shoes and walking barefoot on hard floors may make symptoms worse.
Cold can help after a long day if the heel feels irritated. Pain medicine may help for a short period if it fits your situation and you follow the package instructions.
Long-term recovery and prevention#
Night splints keep the ankle in a gently flexed position so the plantar fascia stays stretched overnight. That can reduce the pain of the first steps in the morning. They are usually used for a few weeks.
Reducing load is important, but complete rest is not usually the answer. Swimming and cycling are good options while the heel settles because they load the foot less than walking or running. Exercise should be built back up gradually.
One common mistake is to stop stretching as soon as the pain eases. Healing is slow, and returning to full load too early often brings the symptoms back.
When to seek care#
Seek care if the heel pain does not improve after a few weeks of self-care, if it is very strong, or if the heel becomes swollen and red. Also seek care if the pain worsens when you put weight on it rather than easing with movement.
Further reading and sources#
Further reading: