Is Your Heel Pain Trying to Tell You Something?
Understanding Heel Pain: Causes, Treatment and When to Seek Help
Heel pain is one of the most common reasons people visit my clinic, and it's easy to see why. Whether it's the sharp pain you feel when you take your first few steps in the morning, discomfort after a long day at work, or an ache that stops you enjoying your favourite walk, heel pain can have a significant impact on your daily life.
The encouraging news is that most heel pain can be managed successfully once the underlying cause has been identified. The key is understanding why it's happening, rather than simply trying to mask the symptoms.
Heel pain isn't always "plantar fasciitis"
One of the biggest misconceptions I hear is that all heel pain is plantar fasciitis.
In reality, there are many different conditions that can cause pain around the heel, including:
Plantar fasciopathy (formerly known as plantar fasciitis)
Heel fat pad syndrome
Achilles tendinopathy
Nerve irritation or entrapment
Stress injuries
Inflammatory conditions such as rheumatoid arthritis
Less commonly, infections or other medical conditions
Although these conditions may feel similar, they require different management. This is why a thorough assessment is so important before beginning treatment.
What is plantar fasciopathy?
The plantar fascia is a thick band of connective tissue that runs from your heel bone to the base of your toes. It supports the arch of your foot and helps absorb the forces created during walking and running.
Repeated strain can cause the tissue to become overloaded. Rather than being a purely inflammatory condition, current research shows that many long-standing cases involve changes to the structure of the tissue itself. This is why the term plantar fasciopathy is now preferred over plantar fasciitis in many cases.
Common symptoms include:
Pain underneath the heel.
Pain with the first few steps after getting out of bed.
Discomfort after periods of sitting.
Pain that eases as you move but may return after prolonged activity.
Tenderness when pressure is applied to the heel.
Why does heel pain develop?
There is rarely a single cause.
Several factors may contribute, including:
Sudden increases in walking, running or exercise.
Standing for long periods at work.
Unsupportive or worn footwear.
Reduced ankle flexibility.
Changes in body weight.
Certain foot types and biomechanics.
Previous lower limb injuries.
Identifying which of these factors applies to you helps determine the most appropriate treatment plan.
How can podiatry help?
Every patient is different, so treatment should always be tailored to the individual.
Following a detailed assessment, your management plan may include:
Advice on activity modification.
Footwear assessment and recommendations.
A personalised programme of stretching and strengthening exercises.
Padding or temporary offloading.
Insoles or orthoses where clinically appropriate.
Advice on managing the condition alongside work, sport or hobbies.
Referral for imaging or onward care if clinically indicated.
Rather than simply treating the pain, the aim is to address the contributing factors and reduce the likelihood of the problem returning.
Choosing supportive footwear
One of the most valuable changes many patients can make is wearing footwear that provides appropriate support.
Look for shoes with:
A firm, stable heel counter.
Adequate cushioning without being excessively soft.
Good midfoot support.
Secure fastening.
A sole that bends at the forefoot rather than twisting through the middle.
While flip-flops and completely flat shoes are comfortable for short periods, they may increase strain on the plantar fascia if worn for prolonged walking.
Should I keep exercising?
This is one of the questions I'm asked most often.
In many cases, the answer is yes—but with modifications.
Completely stopping activity isn't always necessary. Instead, temporarily reducing activities that aggravate your symptoms while introducing appropriate rehabilitation exercises often produces better long-term outcomes.
Returning to higher levels of activity too quickly can delay recovery, so gradual progression is important.
When should you seek professional advice?
Arrange an assessment if:
Your heel pain has lasted more than two weeks.
It is affecting your work or daily activities.
The pain is becoming worse rather than improving.
You have swelling, redness or severe pain.
You have diabetes or another condition that affects circulation or healing.
You are unsure what is causing your symptoms.
Early assessment often leads to earlier treatment and may help prevent a short-term problem becoming a long-term one.
The Take-Home Message
Heel pain is common, but it shouldn't be considered "normal."
While plantar fasciopathy is one of the most frequent causes, it isn't the only one. A thorough assessment allows us to identify the underlying cause, develop an individualised treatment plan and help you return to the activities you enjoy.
If heel pain is limiting your mobility or affecting your quality of life, don't ignore it. Seeking advice early can make all the difference.
References
Martin RL, Davenport TE, Reischl SF, et al. (2023). Heel Pain – Plantar Fasciopathy: Revision Clinical Practice Guideline. Journal of Orthopaedic & Sports Physical Therapy.
National Institute for Health and Care Excellence. Clinical Knowledge Summaries: Heel Pain.
The Royal College of Podiatry. Patient information and evidence-informed guidance on foot health.
National Health Service. Foot pain and plantar heel pain guidance.
Need Help With Heel Pain?
At Bailey Podiatry & Reflexology, every heel pain assessment begins with listening to your story. We'll discuss your symptoms, lifestyle, medical history and activity levels before carrying out a comprehensive clinical assessment to identify the underlying cause.
Together, we'll develop an evidence-informed treatment plan designed to reduce pain, improve function and help you get back to doing the things you enjoy.
Book your appointment today:
📍 The Glen, Main Street, Brampton, CA8 1SB
📞 016977 2191
💻 www.baileypodiatry.co.uk/book
We’re here to help you put your best foot forward — comfortably and confidently.
Bailey Podiatry & Reflexology
Supporting your foot health – and your whole wellbeing
