Heel Pain — Plantar Fasciitis and Other Causes
Also described as plantar fasciitis, pain in sole of foot, heel spur pain.
Sharp heel pain on the first few steps in the morning that eases as you walk is the classic pattern of plantar fasciitis. It is treated with stretching, insoles and footwear changes, and improves in most people within months. A heel spur seen on X-ray is usually a consequence, not the cause.
🚨 Get emergency care if you have
- •Sudden severe pain with a snapping sensation at the back of the heel
- •Heel pain with fever, redness and swelling
- •Inability to push off or stand on tiptoe
- •Numbness in the sole with the pain
- •Heel pain in a person with diabetes and a foot wound
What causes heel pain?
Plantar fasciitis
Pain under the heel, worst on the first steps of the day, eased by walking then returning after rest.
Achilles tendinitis
Pain and thickening at the back of the heel, worse after activity.
Fat pad atrophy
Deep bruise-like pain under the heel, more common with age and in hard footwear.
Nerve entrapment
Burning pain with tingling into the sole, rather than sharply localised tenderness.
Stress fracture
Persistent pain after a change in activity, worse with weight bearing.
How it is investigated
- ✓Examination for point tenderness and calf tightness
- ✓X-ray foot where fracture is suspected
- ✓Ultrasound to assess fascia thickness
- ✓Uric acid and inflammatory markers if inflammatory arthritis is possible
Not every patient needs every test. The consultation decides which of these apply to you.
Frequently asked questions
Does a heel spur need surgery?▼
Almost never. Heel spurs are common in people with no pain at all, and the pain in plantar fasciitis comes from the fascia rather than the spur. Stretching, silicone heel cups, supportive footwear and load management resolve the great majority of cases.
Why is heel pain worst in the morning?▼
The plantar fascia shortens overnight while the foot is relaxed. The first steps stretch it abruptly, which is felt as sharp pain, easing as the tissue warms. Calf and fascia stretches before getting out of bed noticeably reduce that first-step pain.
This page is general health information, not a diagnosis or a substitute for a consultation. Symptoms overlap between harmless and serious conditions, and only an examination can tell them apart. If you are worried, see a doctor.
Plan your first visit
Not sure which specialist to see? Tell our care team the reason for your visit and we will help you choose.
- Bring previous prescriptions, relevant test reports or scan images, a medication list and photo ID.
- If you plan to use insurance, bring your policy details. OPD, tests and admission benefits depend on your individual plan and approval.
- Your first consultation determines which tests or treatments are needed; not everyone needs every test listed on this page.
Appointments are requests until confirmed. In a medical emergency, call 044 2025 2025 or go to the nearest emergency department.