Pain around the heel is most often caused by either Achilles tendon inflammation or heel spur. Both conditions hurt when you get out of bed or after a run, but they affect different tissues and respond differently to rest, exercise, and support products. Below is a comparison to help you recognize the symptoms, understand what is happening in the body, and know when it is time to seek medical care.
Where in the foot is the problem located?
With Achilles tendon inflammation, the Achilles tendon itself is overloaded. Repeated microscopic tears cause the tendon to become thickened and tender a few centimeters above the heel bone. The condition is often described as an overuse injury rather than classic inflammation, but the term remains common in everyday language.
A heel spur, on the other hand, is a bony growth on the underside of the heel bone. It develops after prolonged pulling stress on the plantar fascia, the broad band of connective tissue under the foot. The pain usually comes from the tissue around the attachment itself and is most noticeable under the front part of the heel when the foot bears weight.
How the symptoms feel in everyday life
Achilles tendon inflammation causes stiffness and aching in the tendon when you take your first steps in the morning or start moving after resting. The tenderness is at the back of the heel and may radiate up into the calf. During periods of intense training, the pain may start during the warm-up and sometimes continue after the activity has ended.
A heel spur instead causes a sharp, burning sensation directly under the heel. The first steps after sleeping or sitting for a long time are the worst. Many people describe tiptoeing until the foot has warmed up. The pain often decreases after walking for a while but returns during longer walks or when standing for extended periods. The tenderness is not at the back of the heel but underneath it, near the arch of the foot.
When should you seek medical care?
Reduce the load immediately if you develop pain. If the Achilles tendon does not improve within a week, or if you develop swelling that does not go away, you should contact a healthcare provider. Severe, sudden pain accompanied by a snapping sound may indicate a tear and requires immediate assessment.
If you suspect a heel spur, seek help if self-care does not provide relief within two to three weeks, if you have difficulty standing, or if the pain disrupts your sleep.
Treatment and self-care
Achilles tendon inflammation usually settles with a combination of resting from jumping and running, gradually increasing strength training for the calf muscles, and mobility exercises for the ankle. A stable shoe with good cushioning and a small heel lift can relieve stress on the tendon in the short term. Many people also experience relief from shock-absorbing insoles that reduce the load with each step.
Self-care for a heel spur focuses on reducing pressure on the underside of the heel. Choose shoes with a soft sole, a roomy toe box, and good arch support. Many people get quick relief from soft heel cushions and gel insoles that distribute pressure away from the painful area. Stretching the calf and plantar fascia reduces the pulling force on the heel bone. As with Achilles tendon inflammation, reduce walking and running on hard surfaces, then gradually build up the load.
How to prevent future problems
- Increase your training volume gradually. Do not add more than ten percent of running or walking per week.
- Vary the surfaces you train on and replace worn-out shoes before the cushioning has disappeared.
- Strength-train your calves, ankles, and hips. Strong muscles reduce the load on both the Achilles tendon and plantar fascia.
- Take short breaks if you sit a lot and move your ankles to keep the tissues flexible.
- Several short walks in well-cushioned shoes are often gentler than one long outing.