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Family Foot & Ankle

Where Does It Hurt? Pinpointing Heel Pain

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We can help diagnose your heel painFrom plantar fasciitis to Achilles tendinitis to bone spurs and plenty more, sometimes it seems like there are as many different causes of heel pain as there are feet. Despite the fact that many of these conditions feature broadly similar symptoms, slight differences can help you tell one from another.

To help you narrow down the list of suspects, complete the following part-quiz, part-Choose-Your-Own-Adventure quest:

  1. Is your heel pain primarily located:
  • Beneath your heel? If so, go to question 2.
  • Behind your heel? If so, go to question 3


  1. Do you find that your pain is worst during the first 15 minutes or so after getting out of bed?
  • Yes
  • No.

If you answered “yes” to question 2, the most likely culprit is plantar fasciitis, the most common type of heel pain. It hurts most in the morning because the inflamed tissue contracts at night; once you’ve walked a bit, the tissue stretches and relaxes somewhat.

If you answered “no,” then the answer is a little more complicated. Your most likely suspects in this case include a stone bruise, which is an injury to the fat pad under your heel, or a stress fracture of the calcaneus. Either could be accompanied by bruising, though a stone bruise should improve with rest much faster.

  1. Is there a visible bump at the back of your heel?
  • Yes
  • No

Pain in the back of the heel usually indicates a problem where the Achilles tendon inserts in to that area. A bump there usually indicates either bursitis, which is a swelling of the soft bursa sac, or Haglund’s deformity, an enlargement of bone especially common in young women who wear hard-backed shoes, such as high-heeled pumps.

Achilles tendinitis, which may appear with or without a bump, is another common cause of back-of-heel-pain, and generally worsens gradually over time. However, if the pain is sharp and sudden, you may have partially torn, or even ruptured, the tendon.

Obviously, this quiz is far from complete—it’ll help give you an idea of what you’re up against, but you’ll need to visit Family Foot and Ankle Center for a full evaluation and diagnosis. Trust our experts to assess your condition and get you on the right treatment plan today. Dial (513) 728-4800 or (859) 282-1572 to schedule an appointment at one of our 6 Greater Cincinnati offices.

Dr. Cynthia Miller
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Dr. Cynthia Miller is a board certified podiatrist who has been established in the Cincinnati area since 2004.
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