Heel pain is a common complaint that has many causes. Heel pain may
result from inflammation of the tissue on the bottom of the foot. This is
called plantar fasciitis.
The plantar (foot) fascia (connective tissue) stretches under the skin across the arch of the
foot from the heel to the base of the toes. When this tissue is torn, overused,or
improperly stretched, it can become inflamed (fasciitis). Soreness, tenderness, and pain result. Persons who are overweight,
female, or older than 40 years or who spendlong hours on their feet are especially
at risk of developing plantar fasciitis. Athletes, especially joggers and
runners, may develop plantar fasciitis.
Sometimes plantar fasciitis can be associated with heel spurs. These spurs are outgrowths of bone on the calcaneus (heel bone). They are sometimes painful and may occasionally
require surgical treatment. The September 17,2003, issue of JAMA includes an article about heel pain and plantar fasciitis.
Heel pain, especially in the early morning or after aperiod of
Increasing pain with standing
Pain in the heel after exercising
Arch supports (sometimes called orthotics)
to be worn in shoes
Stretching the calf muscles and Achilles tendon
Nonsteroidal anti-inflammatory drugs (NSAIDs) such asibuprofen
Reducing excess body weight
Corticosteroid injections may be used in select cases
Surgery may be helpful if other treatments are not successful
It is important to understand that all heel pain is not from plantar
fasciitis. Other medical problems can cause foot and heel pain. Diabetes and
blood vessel disease, both serious medical problems, can cause heel pain.
Arthritis, traumatic injury and bruising, gout, stress fractures (caused by repeated stress on bone),and other diseases can also cause
heel pain. Rarely, tumors (either benignor cancerous) or infections can cause
heel pain. If you develop persisting heel pain, see your doctor for an evaluation.
American Academy of Physical Medicine and Rehabilitation 312/464-9700http://www.apmr.org
American Academy of Orthopaedic Surgeons 800/346-AAOShttp://www.aaos.org
American College of Foot and Ankle Surgeons 800/421-2237http://www.acfas.org
American Podiatric Medical Association 800/ASK-APMAhttp://www.apma.org
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Website at http://www.jama.com. Many are available in English and Spanish.
Sources: American Academy of Orthopaedic Surgeons, American College
of Foot and Ankle Surgeons, American Podiatric Medical Association
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
Torpy JM, Lynm C, Glass RM. Plantar Fasciitis. JAMA. 2003;290(11):1542. doi:10.1001/jama.290.11.1444