Why Do My Heels Hurt?

Common reasons heels hurt

The heel absorbs a lot of force when you walk, stand and work. Repeated load can irritate the tissues on the bottom or back of the heel, especially when a sudden change in activity, footwear or work surface is involved. The American Academy of Orthopaedic Surgeons’ heel-pain overview explains why location and timing are useful clues.

• Plantar fascia irritation. Pain is often felt under the heel, particularly with first steps after rest.
• Pressure from footwear. A worn-down insole, tight heel counter or shoe that no longer fits well can make a sensitive area more noticeable.
• Load changes. Longer shifts, more time on concrete, a return to activity or a change in body weight can all increase load through the heel.
• Other causes. Pain at the back of the heel, nerve symptoms, injury or inflammatory conditions need a proper assessment rather than a self-diagnosis.

Notice the pattern of pain

Where and when pain shows up gives useful context. Under-heel pain with first steps is a different pattern from pain behind the heel in a stiff boot, or pain that began after one specific injury.

Keep a short note of what makes it better or worse: first steps, stairs, a particular pair of shoes, long shifts, rest days or a change in workload. That information is useful if you decide to see a clinician.

First steps at home

Reduce the aggravating load where you can, rather than trying to push through increasing pain. Choose footwear with enough room and a stable fit, and check whether the original insole is compressed, uneven or worn through.

• Ease back on the activity that reliably brings pain on.
• Use supportive, well-fitting footwear instead of thin or collapsed liners.
• Try gentle calf and foot movement if it is comfortable. Stop if it causes sharp pain.
• Replace worn insoles instead of stacking new inserts on top of old ones.

Make a workday plan, not a one-day fix

Heel pain often responds better to a few repeatable changes than to one dramatic change of shoe or insert. Start by identifying the part of the day that consistently aggravates it: the first ten minutes, a long spell on concrete, climbing stairs, or the walk home. That pattern helps you change the right variable.

For a long standing shift, check that your heel is sitting fully back in the shoe, the laces hold the foot without crushing the top, and the shoe is not visibly leaning or worn through. If you have a choice, alternate footwear rather than putting every shift through the same pair. Build in short movement breaks where practical; changing position is usually more useful than simply standing still for longer.

When to get assessed

Get prompt medical advice after a sudden injury, if you cannot bear weight, or if the area is hot, very swollen, numb or visibly changed. Persistent pain, pain that is getting worse, or pain that keeps affecting work and sleep also deserves an assessment.