Foot Specialists of Birmingham

Where Your Feet
Are In Good Hands

Symptoms, Causes and Treatment of Heel & Arch Pain

Heel problems are common and can be painful. Often, they result from too much stress on your heel bone and the tissues that surround it. That stress can come from:

  • Injuries
  • Bruises that you get walking, running, or jumping
  • Wearing shoes that don't fit or aren't made well
  • Being overweight
  • Lack of flexibility

These can lead to tendonitis, bursitis and fasciitis, which are all types of inflammation of the tissues that surround your heel. Over time the stress can cause bone spurs and deformities. Certain diseases, such as rheumatoid arthritis and gout, can also lead to heel problems. Treatments for heel problems might include rest, medicines, exercises, taping and special shoes. Surgery is rarely needed.

Heel Pain/Plantar Fasciitis


Most frequently heel pain is not the result of any single injury, such as a fall or twist, but rather the result of repetitive or excessive heel pounding.

Plantar fasciitis is inflammation of the thick connective tissue on the sole of your foot that attaches to your heel. The pain is usually felt at the bottom of your heel and is often worse in the morning because of stiffness that occurs overnight. The following increase your risk of developing this painful problem:

  • Shoes with poor arch support or soft soles
  • Quick turns that put stress on your foot
  • Tight calf muscles
  • Change in activities
  • Change in shoe type

Repetitive pounding on your feet from long-distance running, especially running downhill or on uneven surfaces.

Pronation -- landing on the outside of your foot and rolling inward when walking or running; to know if you pronate, check the soles of your shoes to see if they are worn along the outer edge

Bone spurs in the heel can accompany plantar fasciitis, but are generally not the source of the pain. If you treat the plantar fasciitis appropriately, the bone spur is likely to no longer bother you.

Heel bursitis (inflammation of the back of the heel) can be caused by landing hard or awkwardly on the heel, or by pressure from shoes.

Arch pain

Arch pain has often been described as a burning feeling or sensation in the long arch of the foot. There can be many causes for this, such as a strain to any one of the structures of the foot. However, the most common cause of arch pain has been found to be plantar fasciitis.

Management of arch pain

A factor in the early management of arch pain is receiving an accurate diagnosis from your physician here at Foot Specialists of Birmingham. If the symptoms are generally mild our physicians may consult with you about foot orthotics and stretching exercises to help the calf muscles and arch. If you report that your symptoms are more severe than our physicians may use tape to support the arch and restrict movement as well as prescribe an anti-inflammatory medication, and recommend the use of orthotics. If there is no relief from those treatments, further testing may be necessary to determine whether other conditions may exist.

Arthritis information was provided by the Centers for Disease Control and Prevention

Achilles Tendonitis

Achilles tendonitis is inflammation, irritation, and swelling of the Achilles tendon (the tendon that connects the muscles of the calf to the heel).


There are two large muscles in the calf, the gastrocnemius, and soleus. These muscles generate the power for pushing off with the foot or going up on the toes. The large Achilles tendon connects these muscles to the heel.

These are important muscles for walking. This tendon can become inflamed, most commonly as a result of overuse or arthritis, although inflammation can also be associated with trauma and infection.

Tendonitis due to overuse is most common in younger individuals and can occur in walkers, runners, or other athletes, especially in sports like basketball that involve jumping. Jumping places a large amount of stress on the Achilles tendon.

Tendonitis from arthritis is more common in the middle aged and elderly population.


Symptoms usually include pain in the heel when walking or running. The tendon is usually painful to touch and the skin over the tendon may be swollen and warm.

Exams and Tests

The doctor will perform a physical exam and look for tenderness along the tendon and for pain in the area of the tendon when you stand on your toes.

Imaging studies can also be helpful. X-Rays can help diagnose arthritis and an MRI or in office diagnostic ultrasound will show inflammation in the tendon.

Outlook (Prognosis)

Conservative therapy usually helps improve symptoms. However, symptoms may return if activities that cause the pain are not limited, or if the strength and flexibility of the tendon is not maintained.

Surgery, if needed, has been shown to be very effective in improving pain symptoms.

Possible Complications

Achilles tendonitis may make you more likely to have an Achilles rupture. This condition usually causes a sharp pain, like someone hit you in the back of the heel with a stick. Surgical repair is necessary, but difficult because the tendon is not normal.

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