You've recently developed heel pain and you're wondering what could be causing it. Heel pain is one of the most frequent problems that we treat at the Foot and Ankle Center of Lake City. And it's the top reason many of our active patients stop doing the things they love. Dr. Rion Berg has over 30 years of experience successfully treating all forms of heel pain.

Here are the most common causes of heel pain:

Person With Heel PainPlantar Fasciitis

Plantar fasciitis is the most common cause of heel pain. It's an inflammation of connective tissue called the plantar fascia. This tissue starts at your heel, travels across your arches, and inserts into the base of your toes.

If you have pain in your feet when they hit the floor first thing in the morning, it’s very likely you have this condition. The pain decreases as the foot becomes warmed up, but will return after standing for long periods or after sitting for a long time.

Learn more about plantar fasciitis and how it's treated here!

Person With Pain in Back of HeelAchilles Tendonitis

The Achilles tendon is largest tendon in the body. It can withstand up to 1,000 pounds of force or more. When this tendon is overstressed Achilles tendonitis or an inflammation of the Achilles can develop. When the Achilles tendon is stretched beyond its capacity it can rupture. Both professional athletes and weekend warriors are at risk for developing Achilles tendonitis. It can manifest as aching, stiffness and soreness, or intense pain where the Achilles attaches above the heel to the area just below the calf muscle.

Achilles Tendonosis

Achilles tendonosis is a degeneration of the collagen protein that forms the tendon. It typically occurs in response to chronic overuse without adequate time to heal and rest.

Children playing soccerSever's Disease

Sever's disease is the most common cause of heel pain in children. Found frequently in youth athletes between the ages of 8-14 symptoms range from pain in the back or bottom of the heel, toe walking, and difficulty continuing with physical activity. Until age 14 the heel's growth plate is not fully developed making it vulnerable to repetitive stress.

X-Ray showing heel spurHeel Spurs

Sometimes heel spurs are found in people with plantar fasciitis, but they don't usually cause pain. They are bony growths on the underside of the heel bone caused by stress on the plantar fascia.

Haglund's Deformity

Pain and inflammation in the back of the heel may be a condition called Haglund's Deformity. This condition can develop as a result of wearing pumps or shoes too stiff in the heel, thus the informal name "Pump Bump". However, it can also develop in people with high arches, a tight Achilles tendon, or faulty foot mechanics. This condition can lead to bursitis.

Stress Fracture

Stress fractures are common and are most often found in runners and other athletes. They can also occur in women who have bone loss or in people with faulty foot mechanics. Symptoms of this condition can include pain, swelling, redness, and bruising.

Posterior Tibial Tendon Dysfunction 

Posterior tibial tendon dysfunction (PTTD) is an inflammation and/or overstretching of the posterior tibial tendon in the foot. This tendon connects the calf muscle to the bones located on the inner foot. One of the most important functions of the posterior tibial tendon is to support the arch while you walk. In PTTD the function of the posterior tibial tendon is impaired resulting in flattening of the foot. Pain can be felt anywhere along the tendon, from the bottom of the arch to the inside of the ankle.

Insertional Pain of the Achilles Tendon

Insertional pain of the Achilles Tendon occurs at the site where the Achilles tendon inserts on the back of the heel bone. The tendon and its covering become inflamed and a heel spur may form as a result. This condition is most often caused by overuse of the Achilles, a flatfoot deformity, or an injury.

Tarsal Tunnel Syndrome

The foot has a tunnel that allows the major nerves to pass from the ankle to the foot. When this narrow passageway on the inside of your heel becomes compressed it results in pain in the inside of the ankle or bottom of the foot, or Tarsal Tunnel Syndrome. It's often caused by trauma, flat feet, cysts, or arthritis.

Tarsal Coalition

A tarsal coalition is an abnormal connection between two bones in the back of the foot (the tarsal bones). This abnormal connection may lead to limited motion and pain in one or both feet. Most people are born with this condition although it can also develop as the result of infection, arthritis, or an injury. Symptoms of this condition are pain, fatigued legs with muscles spasms, stiffness of the foot and ankle, and walking with a limp.

Treatment for Heel Pain

Treatment for heel pain can vary depending on the particular condition. Here are some of the most common treatments we use to treat these conditions.

Modalities to Reduce Inflammation

Many of these conditions result in inflammation. Recommendations may include using ice, anti-inflammatory medications, cortisone injection, MLS laser therapy, low dye taping, use of an air heel, and ceasing physical activity.


Tight calf muscles are often a big factor in heel pain. To resolve your pain adequate stretching is essential. Dr. Rion Berg recommends his patients use an Achilles splint for 30 minutes 1-2 times a day to get an ample stretch.

Custom Orthotics

Many of these conditions result from a combination of factors including faulty foot mechanics. When the biomechanics of your foot are off balance custom foot orthotics can be a long term solution in prevention of future problems.

MLS Laser Therapy

In addition to reducing inflammation, MLS laser therapy can reduce pain and speed healing for many of these conditions.

Proper Footgear

Something as simple as a change in shoes can make a big different in relieving heel pain. Dr. Rion Berg will recommend specific types of shoes for your particular condition.


Some conditions require immobilization to enable healing. Most often Dr. Berg will provide a walking boot to patients who need this.

Physical Therapy

Dr. Berg will frequently refer patients for physical therapy for additional stretching, massage, and strengthening.

Dr. Rion Berg
Connect with me
A podiatrist in North Seattle treating families for over 40 years.