Foot
Heel pain
Pain felt under or behind the heel — often sharpest on the first steps in the morning — that usually comes from strain of the tissues and tendons of the foot, but can occasionally reflect inflammatory arthritis, gout, a tendon rupture or infection.
Education and reference only. This explains the common causes of heel pain and the warning signs that need urgent help, in plain language — it is not a diagnosis or a substitute for advice from a clinician. If you feel very unwell or are worried, seek medical help.
Quick answer
What is heel pain?
Heel pain is a common complaint that can make every step uncomfortable. The commonest cause by far is plantar fasciitis, an irritation of the thick band of tissue running along the sole of the foot, which classically produces a stabbing pain under the heel that is worst with the first steps in the morning or after sitting, and eases a little once you get moving.
- Get urgent help: Seek urgent help if you felt a sudden pop or snap at the back of the heel and cannot push off or rise onto your toes — this can mean a ruptured Achilles tendon. Seek a same-day appointment for a hot, red, swollen heel with fever or feeling unwell, which can indicate infection.
- Self-care: For ordinary strain-related heel pain, the mainstays are rest, time and sensible footwear.
About heel pain
Heel pain is a common complaint that can make every step uncomfortable. The commonest cause by far is plantar fasciitis, an irritation of the thick band of tissue running along the sole of the foot, which classically produces a stabbing pain under the heel that is worst with the first steps in the morning or after sitting, and eases a little once you get moving. Pain at the back of the heel, by contrast, often comes from the Achilles tendon, the strong cord linking the calf to the heel bone. Heel pain can also be one of the places where inflammatory joint conditions show themselves, particularly where tendons attach to bone, and gout occasionally strikes the heel. The character matters: a sudden pop or snap with an inability to push off the foot suggests a tendon rupture, and a hot, swollen, red heel with fever raises concern about infection — both need urgent attention rather than rest alone.
When to get help
Call 999 or go to A&E if heel pain comes with any of these warning signs:
- Seek urgent help if you felt a sudden pop or snap at the back of the heel and cannot push off or rise onto your toes — this can mean a ruptured Achilles tendon.
- Seek a same-day appointment for a hot, red, swollen heel with fever or feeling unwell, which can indicate infection.
- Get assessed for severe heel pain following a fall or injury, or if you cannot put weight on the foot.
- Arrange review if heel pain comes with pain and stiffness in the spine or other joints, especially in a younger adult, suggesting inflammatory arthritis.
- Seek advice if there is numbness, tingling or pins and needles spreading into the foot alongside the heel pain.
When to see a doctor
Most heel pain settles with rest, supportive footwear and stretches over a few weeks, so you can usually start with self-care. See a doctor or a foot specialist if the pain is severe, is not improving after several weeks of sensible measures, or is stopping you walking or working. Treat a sudden pop or snap with inability to push off the foot, or a hot, red, swollen heel with fever, as urgent. Heel pain that comes with back or joint stiffness, particularly in a younger person, or with numbness spreading into the foot, also deserves assessment to look for an underlying cause.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
What can cause it
Common causes of heel pain
Heel pain has many possible causes. Each links to a full, plain-language guide to that condition — what it is, how it's treated and when to seek help.
What helps
Self-care and what you can do
For ordinary strain-related heel pain, the mainstays are rest, time and sensible footwear. Cut back on activities that pound the heel, such as running or long periods standing on hard floors, and wear cushioned, supportive shoes rather than going barefoot or wearing flat, unsupportive ones. A cushioning heel pad or arch support can help spread the load. Gentle, regular stretches of the calf and the sole of the foot, particularly before the first steps of the day, often ease plantar fasciitis over weeks. An ice pack wrapped in a cloth can settle a sore, inflamed heel. Losing excess weight reduces the load through the heel. Improvement is usually gradual, so persistence matters; if there is no progress after several weeks, seek advice.
Answers
Heel pain: frequently asked questions
Why is my heel pain worst in the morning?
Pain that is sharpest on the first steps of the day, easing as you move, is the classic pattern of plantar fasciitis. The tissue along the sole tightens overnight and is stretched painfully when you stand.
When should I worry about heel pain?
Worrying features include a sudden pop or snap with inability to push off the foot, a hot red swollen heel with fever, inability to bear weight after an injury, or heel pain with spinal or joint stiffness. These need prompt assessment.
Can the wrong shoes cause heel pain?
Yes. Flat, worn or unsupportive shoes, and spending long periods barefoot on hard floors, all increase strain on the heel. Cushioned, supportive footwear is one of the most helpful self-care measures.
How long does heel pain take to settle?
Strain-related heel pain such as plantar fasciitis often improves over several weeks to months with rest, stretches and good footwear. If there is no progress after a few weeks of self-care, it is worth seeking advice.
Sources
Where this is drawn from
- NICE CKS: Plantar fasciitis.
- Versus Arthritis: foot pain.
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