From Jonathan Cluett, M.D.,
Your Guide to Orthopedics.
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About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

Heel pain is an extremely common complaint, and there are several common causes. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the cause. If you have heel pain, some causes include:

• Plantar Fasciitis
  Plantar fasciitis is the most common condition that causes heel pain. Plantar fasciitis is due to irritation and inflammation of the tight tissue that forms the arch of the foot. Common symptoms of plantar fasciitis include heel pain with prolonged walking and standing.

• Heel Spur
  A spur is commonly associated with plantar fasciitis. This problem is most commonly seen in patients who have long standing heel pain due to plantar fasciitis.

• Tarsal Tunnel Syndrome
  Tarsal tunnel syndrome causes a large nerve in the back of the foot to become entrapped, or pinched. Similar to carpal tunnel syndrome in the hand, tarsal tunnel syndrome can cause heel pain.

• Stress Fractures
  Stress fractures of the calcaneus are an uncommon cause of heel pain. Stress fractures should be considered especially in athletes such as long distance runners who have heel pain.

• Posterior Heel Pain
  Posterior heel pain causes symptoms behind the foot, rather than underneath. Posterior heel pain causes include Achilles tendonitis and retrocalcaneal bursitis. Learn about causes of posterior heel pain and what treatments are available.

When do you need to call your doctor about your heel pain?
If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of heel pain must be directed at the specific cause of your problem. Some signs that you should be seen by a doctor include:

• Inability to walk comfortably on the affected side
• Heel pain that occurs at night or while resting
• Heel pain that persists beyond a few days
• Swelling or discoloration of the back of the foot
• Signs of an infection, including fever, redness, warmth
• Any other unusual symptoms

What are the best treatments for heel pain?
Treatment of heel pain depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment plan.

Some common treatments for heel pain are listed here. Not all of these treatments are appropriate for every condition, but they may be helpful in your situation.

• Rest
  Avoiding the precipitating activity; for example, take a few day off jogging or prolonged standing/walking. Just resting usually helps to eliminate the most severe pain, and will allow the inflammation to begin to cool down.

• Apply Ice Packs
  Icing will help to diminish some of the symptoms and control the heel pain. Icing is especially helpful after an acute exacerbation of symptoms.

• Exercises and Stretches
  Exercises and stretches are designed to relax the tissues that surround the heel bone. Some simple exercises, performed in the morning and evening, often help patients feel better quickly.

• Anti-Inflammatory Medications
  Anti-inflammatory medications help to both control heel pain and decrease inflammation. Over-the-counter medications are usually sufficient, but prescription options are also available.

• Shoe Inserts
  Shoe inserts are often the key to successful treatment of heel pain. The shoe inserts often permit patients to continue their routine activities without heel pain.