Heel Pain: Symptoms and Possible Causes Explained - Rehabilitation

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Heel pain


Hello, doctor...
I would like to ask about a symptom I have.
There is pain when pressing about two centimeters above the front of my heel, and it also hurts when walking in flip-flops.
Walking barefoot is somewhat better and less painful, but when sitting and resting, I don't feel pain, just a soreness.
What could this symptom indicate? Could it be plantar fasciitis? I haven't been walking or exercising much lately, and the pain started when I woke up yesterday morning.
Thank you for your help.

Mr. Hong, 30~39 year old female. Ask Date: 2021/05/04

Dr. Wang Zhaomin reply Rehabilitation


Based on the description, it is not possible to diagnose as each individual's condition varies.
A proper assessment can only be made through an in-person examination.
Online consultations cannot replace actual medical visits.
Please consult an orthopedic or rehabilitation specialist for an accurate diagnosis and to arrange appropriate treatment.

Reply Date: 2021/05/04

More Info


Heel pain can be a common complaint and can arise from various underlying conditions. Based on your description, it sounds like you may be experiencing symptoms consistent with plantar fasciitis, although there are other potential causes to consider as well.

Symptoms and Characteristics:
1. Location of Pain: You mentioned that the pain is located about two centimeters above the heel, which is a typical area affected by plantar fasciitis. This condition often presents with pain at the bottom of the foot near the heel, especially after periods of inactivity, such as after waking up in the morning or after sitting for a long time.


2. Pain with Activity: The fact that walking in flip-flops causes pain but walking barefoot alleviates it somewhat suggests that the type of footwear may be contributing to your discomfort. Flip-flops often lack arch support and cushioning, which can exacerbate heel pain.

3. Resting Symptoms: The pain subsiding when sitting and only feeling a dull ache indicates that the pain is likely related to the stress placed on the plantar fascia during weight-bearing activities.

Possible Causes:
1. Plantar Fasciitis: This is the most common cause of heel pain and occurs when the plantar fascia, a thick band of tissue that runs across the bottom of your foot, becomes inflamed. Risk factors include obesity, prolonged standing, and inadequate footwear.

2. Achilles Tendinitis: This condition involves inflammation of the Achilles tendon, which can cause pain in the heel area, particularly during movement.

3. Heel Spurs: These are bony growths on the underside of the heel bone that can develop due to chronic inflammation of the plantar fascia. They may not always cause pain but can be associated with plantar fasciitis.

4. Bursitis: Inflammation of the bursa (a fluid-filled sac that reduces friction) near the heel can also lead to pain.

5. Tarsal Tunnel Syndrome: This condition occurs when the posterior tibial nerve is compressed as it passes through the tarsal tunnel, leading to pain and discomfort in the heel area.

Management and Recommendations:
1. Footwear: Consider wearing supportive shoes with good arch support and cushioning. Avoid flip-flops or shoes with inadequate support.

2. Stretching Exercises: Stretching the calf muscles and the plantar fascia can help alleviate tension. Simple exercises like calf stretches and rolling your foot over a frozen water bottle can be beneficial.

3. Rest and Ice: If the pain worsens with activity, resting and applying ice to the affected area can help reduce inflammation.

4. Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and inflammation.

5. Physical Therapy: If symptoms persist, a physical therapist can provide tailored exercises and treatments to strengthen the foot and improve flexibility.

6. Consult a Specialist: If the pain continues despite conservative measures, it may be wise to consult a podiatrist or orthopedic specialist for further evaluation. They may recommend imaging studies, such as X-rays or an MRI, to rule out other conditions.

In conclusion, while your symptoms are suggestive of plantar fasciitis, it is essential to consider other potential causes. Proper footwear, stretching, and rest are critical components of managing heel pain. If symptoms persist or worsen, seeking professional medical advice is recommended to ensure an accurate diagnosis and appropriate treatment plan.

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