The Science Behind Heel Pain: Is It Plantar Fasciitis or Something Else?
Wiki Article
If you’ve ever woken up and taken those first painful foot & ankle specialists, steps in the morning, you know how frustrating heel pain can be. Most people immediately assume it’s plantar fasciitis—and to be fair, it often is. But heel pain can have multiple causes, and understanding the science behind it can help you get the right treatment and get back on your feet (literally).
So what’s going on in your heel, and how can you tell what’s really causing the pain?
What Is Plantar Fasciitis?
Let’s start with the most common culprit: plantar fasciitis.
At the bottom of your foot, there’s a thick band of tissue called the plantar fascia. It connects your heel bone to your toes and acts like a shock absorber. If this tissue becomes inflamed or overstretched, it can cause stabbing pain—usually near the heel and often worse in the morning or after long periods of rest.
What Causes It?
Overuse (common in runners and athletes)
Flat feet or high arches
Improper footwear
Prolonged standing
Tight calf muscles
The good news? Plantar fasciitis usually improves with rest, stretching, supportive shoes, and sometimes physical therapy or orthotics.
But What If It’s Not Plantar Fasciitis?
Here’s where things get interesting. Not all heel pain is caused by plantar fasciitis. There are several other possible conditions that can mimic its symptoms.
1. Heel Spurs
Heel spurs are calcium deposits that cause a bony protrusion on the underside of the heel bone. While they often coexist with plantar fasciitis, they don’t always cause pain themselves.
Key difference: Heel spurs may show up on an X-ray, whereas plantar fasciitis doesn’t.
2. Achilles Tendinitis
Pain at the back of the heel? That might be Achilles tendinitis. This inflammation of the Achilles tendon often comes from overuse, tight calves, or sudden increases in activity.
Key symptoms: Pain that worsens with activity, swelling in the back of the heel, and stiffness that improves with movement.
3. Bursitis
Bursae are small, fluid-filled sacs that cushion your joints. When the bursa near your heel becomes inflamed (retrocalcaneal bursitis), it can lead to persistent pain, especially during walking or wearing tight shoes.