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If your heel hurts when you walk, plantar fasciitis is one possible cause – but it isn’t the only one.
Heel pain can also come from irritation of the Achilles tendon, a bruised heel, changes in foot mechanics, overuse, or less commonly a stress fracture or nerve problem.
Where your heel hurts, when the pain occurs, and what makes it better or worse can provide useful clues.
Why Does My Heel Hurt When I Walk?
Walking places repeated load through the heel and the tissues that support the foot.
If one of these structures becomes irritated or overloaded, you may notice pain each time your foot contacts the ground or as you push off into your next step.
You might experience:
- Pain underneath the heel
- Pain at the back of the heel
- Sharp pain during your first few steps in the morning
- Heel pain after sitting for a long time
- Aching after prolonged walking or standing
- Pain that becomes worse when walking barefoot
- Tenderness when you press on the heel
One of the most important clues is the location and pattern of your pain.
Plantar Fasciitis and Heel Pain
Plantar fasciitis is one of the most common causes of pain underneath the heel.
The plantar fascia is a strong band of connective tissue that runs from the heel toward the toes. It helps support the arch and manage forces as you stand and walk.
When this tissue becomes irritated, pain often develops near the inside of the bottom of the heel.
A classic symptom is pain during the first few steps after getting out of bed. The discomfort may improve once you start moving, only to return after prolonged standing or walking.
Changes in activity, running, prolonged standing, tight calf muscles, reduced ankle mobility, footwear, and foot mechanics can all influence the load placed on the plantar fascia.
Could My Achilles Tendon Be Causing the Pain?
If the pain is mainly at the back of your heel, the Achilles tendon may be involved.
The Achilles tendon connects your calf muscles to the heel. Repetitive loading from running, walking, climbing hills, or suddenly increasing your activity can irritate the tendon.
Achilles problems may cause:
- Pain behind or just above the heel
- Morning stiffness
- Tenderness along the tendon
- Pain when walking uphill or climbing stairs
- Discomfort when pushing off the foot
The location is an important distinction. Plantar fascia pain is usually underneath the heel, while Achilles pain tends to occur behind it.
Other Causes of Heel Pain When Walking
Not every painful heel is plantar fasciitis.
Other possibilities include:
Heel Pad Irritation
The natural fatty pad beneath your heel helps absorb impact.
Repeated pounding, hard surfaces, or changes in footwear can sometimes irritate this area. The pain may feel more like a deep bruise in the centre of the heel.
Stress Fracture
Repetitive loading can occasionally produce a small stress fracture in the heel bone.
This is more concerning when pain progressively worsens with activity, remains painful at rest, or follows a significant increase in running or other weight-bearing exercise.
Nerve Irritation
Burning, tingling, numbness, or electric-type pain may suggest that a nerve is involved.
In these cases, it’s important to determine whether the irritation is occurring locally in the foot and ankle or elsewhere along the nerve pathway all the way up into the spine.
Arthritis or Inflammatory Conditions
Although less common, certain types of arthritis and inflammatory conditions can also cause heel pain.
That’s one reason persistent heel pain shouldn’t automatically be labelled plantar fasciitis without an appropriate examination.
Can Flat Feet Cause Heel Pain?
Your foot doesn’t work in isolation.
The shape and movement of your arch influence how forces travel through the foot during walking.
Having flat feet doesn’t automatically mean you’ll develop heel pain. Many people with flat feet have no symptoms at all.
However, excessive or poorly controlled foot motion may increase stress on certain tissues in some people.
That’s why I prefer to assess how the foot functions, rather than simply looking at whether an arch appears high or low.
An examination may also include your ankle mobility, calf flexibility, footwear, walking pattern, and the way your knees and hips are functioning.
Can Orthotics Help Heel Pain?
Sometimes.
Orthotics can help redistribute pressure and support the foot when mechanics are contributing to the problem. However, not every person with heel pain needs custom orthotics.
Treatment should be based on the cause of the pain rather than simply the location of the symptom.
For some patients, footwear changes, stretching, strengthening, activity modification, manual treatment, or improving ankle and foot mobility may be more important.
For others, orthotic support can be a useful part of the overall plan.
How We Assess Heel Pain at Our Edmonton Clinic
When someone comes to our Edmonton chiropractic clinic with heel pain, I don’t want to assume the diagnosis before examining the foot.
I want to know:
- Exactly where does it hurt?
- Did it start suddenly or gradually?
- Is it worse first thing in the morning?
- Does it improve after you start moving?
- What happens after prolonged walking?
- Have you recently changed your activity or footwear?
- Is there numbness, tingling, swelling, or weakness?
I then assess the foot and ankle, including joint movement, muscle function, flexibility, and foot mechanics.
I will also examine the knee, hip, and lower back. These areas work together whenever you stand, walk, or run.
The goal is to identify why your heel is being irritated, not simply chase the painful spot.
When Should Heel Pain Be Checked?
A mildly sore heel after an unusually active day may settle with rest and sensible activity modification.
However, consider having it assessed when:
- The pain persists or keeps returning
- Walking is becoming increasingly uncomfortable
- You are changing the way you walk because of the pain
- The heel is significantly swollen
- Pain developed after an injury
- You cannot comfortably bear weight
- You have persistent numbness, tingling, or burning
- The pain is interfering with work, exercise, or everyday activities
Severe pain after an injury, inability to bear weight, marked swelling, or signs of infection warrant prompt medical assessment.
Heel Pain Treatment in Edmonton
Heel pain can be frustrating because every step reminds you that something isn’t right.
Fortunately, many common causes of heel pain respond well to conservative care once the contributing factors have been identified.
At Collins Chiropractic Health & Wellness Centre, we assess the foot, ankle, lower limb, spine, and movement patterns that may be contributing to your symptoms.
Treatment may include adjustments when appropriate, soft tissue therapy, stretching and strengthening exercises, activity advice, footwear recommendations, and orthotics when indicated.
If heel pain is making walking, exercising, or standing uncomfortable, learn more about our Foot & Ankle Pain Treatment in Edmonton or contact our clinic to arrange an assessment.
Frequently Asked Questions
Pain during the first few steps in the morning is commonly associated with plantar fasciitis. The discomfort often improves after moving for a while, although it may return later after prolonged standing or walking.
No. Achilles tendon problems, heel pad irritation, stress fractures, nerve irritation, arthritis, and other conditions can also cause heel pain.
That depends on the severity and cause of your pain. Mild discomfort may respond to temporarily reducing aggravating activities. Pain that worsens with walking, persists, or changes your gait should be assessed.
They can. Calf flexibility and ankle mobility influence how the foot moves during walking. Reduced ankle movement may increase loading on other structures in the foot.
Chiropractic care may be appropriate for some mechanical causes of heel pain. An assessment can help determine what structures are involved and whether treatment, rehabilitation, footwear changes, orthotics, or referral for additional evaluation is appropriate.
Still dealing with heel pain when you walk?
If heel pain is limiting your walking, exercise, or daily activities, we can help determine what may be contributing to the problem. Learn more about our Foot & Ankle Pain Treatment in Edmonton, or book an appointment with Dr. Collins for a thorough assessment and personalized treatment plan.
About Dr. Dean Collins
Dr. Dean Collins has been helping Edmonton patients improve their health through chiropractic care since 1998. With over 30 years of clinical experience, he has worked with patients of all ages, helping them reduce pain, improve mobility, and maintain healthier, more active lives. At Collins Chiropractic Health & Wellness Centre, Dr. Collins focuses on identifying the underlying causes of pain and dysfunction while providing personalized care, education, and practical strategies to support long-term health and wellness.
Learn more about Dr. Collins or book an appointment today.
To learn more about how chiropractor care can help you and your family, read Dr. Collins’ comprehensive guide to chiropractic care: Chiropractic Care for Everyone.
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