Overview

As the largest of the foot’s 26 bones, the heel is often susceptible to pain and injury due to its position and vital functions. Common heel pain itself is rarely a severe medical condition, but it can be a sign of something a little more serious. For example, discomfort on the underside usually stems from plantar fasciitis, while pain on the back of the heel is frequently associated with Achilles tendinitis. 

Most Common Causes

As mentioned above, the following two conditions are the most common causes of intense heel pain:

Plantar Fasciitis – An inflammation of the plantar fascia connective tissue, which runs from the heel to the front of the foot. Specifically, plantar fasciitis develops when the plantar fascia tendon becomes strained over time. This can be due to a number of different reasons, but the most common is athletic activity. On the other hand, improperly fitting shoes with insufficient arch support will also aggravate the plantar fasciitis and cause increased heel pain.

Achilles Tendinitis – An inflammation of the Achilles tendon, which runs down the backside of the ankle and into the heel. Achilles tendinitis occurs near the heel bone when this sensitive tendon is strained, usually over a long period of time. This condition is most frequently seen in older individuals who still walk and run for exercise.

Other Causes

Heel Spurs – A hard, unnatural growth on the bottom of the heel bone that is often associated with plantar fasciitis.

Heel Bursitis – This is an inflammation or swelling of the bursa, a fluid-filled sac at the back of the heel – under the Achilles tendon. It is most often caused by wearing shoes that put too much pressure on this part of the foot or wearing heels that do not properly fit.

Arthritis – More specifically, osteoarthritis and rheumatoid arthritis.

Stress Fracture – A fracture, or break in the heel bone, caused by repetitive stress. This particular cause is most commonly seen amongst competitive athletes and runners.