Ouch! My heel hurts
4/14/2025 by Denise Dupras, M.D., Ph.D.
Heel pain is a frequent problem. Often, the diagnosis is made based on the patient's history and physical examination alone. The most common cause of heel pain is plantar fasciitis. This condition affects about 1 in 10 adults.
Risk factors include:
- Age: most common between 40 and 60 years of age.
- Gender: more common in women than men.
- Obesity.
- Foot mechanics: flat foot or high arch.
- Occupation: increased time on your feet — especially on hard surfaces.
Symptoms typically include sharp stabbing pain in the bottom of the foot near the heel. It's often the worst with the first few steps after getting out of bed in the morning or after a rest period and may get better after walking around. You often can't see anything when you look at the foot or heel, and plantar fasciitis is typically not associated with an injury.
The plantar fascia connects the heel bone to the base of your toes and supports the arch of the foot. It's thought that tension and stress can result in small tears, irritation or inflammation that cause the pain at the fascia insertion into the heel bone.
The diagnosis can be made without the need for X-rays or MRI testing. Your healthcare clinician can usually find a tender spot on your heel and make the diagnosis.
The primary treatment involves:
- Using ice to decrease inflammation multiple times a day.
- Taking an anti-inflammatory medication such as ibuprofen (be sure to ask your healthcare clinician if it is safe to use these medications).
- Stretching the plantar fascia.
- Avoiding activities that increase pain.
- Sometimes, getting night splints to keep your foot bent to 90 degrees while you sleep.
Be patient; it can take a while for this condition to improve. Rarely, additional treatments need to be considered, including injections, shock wave therapy, ultrasound tissue repair or surgery.
Denise Dupras, M.D., Ph.D., is a physician in Primary Care in Rochester and Kasson's Division of Community Internal Medicine, Geriatrics and Palliative Care. She completed her medical and doctoral degrees at Mayo Clinic Alix School of Medicine and her residency in internal medicine at Mayo Clinic in Rochester. Her interests include medical education and evidence-based medicine.