Many people assume heel pain is caused by one issue alone, often blaming heel spurs or poor footwear. But the truth is, multiple foot conditions and lifestyle factors can contribute to both acute and chronic heel pain. Without an accurate diagnosis, even the most diligent at-home care may not lead to lasting relief.
At Paragon Podiatry, conveniently located in Manhattan, East Setauket, and the Bronx, our board-certified podiatrists specialize in diagnosing and treating foot and ankle conditions with a focus on conservative, non-invasive care. If you're experiencing pain in the heel or plantar surface of your foot, understanding the real cause is the first step toward recovery.
Below, we address some of the most common heel pain myths and explain how to approach proper diagnosis and treatment.
Misconception #1: Heel Spurs Are the Main Cause of Heel Pain
Heel spurs—small bony growths on the heel bone—are often found on imaging when patients report heel pain. However, heel spurs are often misunderstood. While these bony projections may be present, they are rarely the actual source of pain.
In many cases, the pain stems from inflammation of the plantar fascia, the fibrous tissue along the bottom of your foot. This condition is known as plantar fasciitis, and it's one of the most common causes of heel pain in clinical practice.
The confusion arises because heel spurs often develop as a response to chronic plantar heel pain but don’t typically cause pain themselves.
Misconception #2: Achilles Tendonitis Only Affects Athletes
Another common misconception is that Achilles tendonitis—a painful inflammation of the Achilles tendon at the back of the heel—only affects athletes. While athletes are at higher risk, anyone can develop Achilles tendonitis due to factors such as tight tendons, wearing poorly fitted shoes, or having structural foot problems.
Achilles Tendonitis Causes:
This condition results from repetitive stress or chronic inflammation of the Achilles tendon, typically causing posterior heel pain. Common contributing factors include:
- Sudden increase in physical activity or intensity
- Tight calf muscles or limited passive dorsiflexion of the ankle
- Wearing unsupportive or poorly cushioned footwear
- Biomechanical issues, such as flat feet or abnormal foot mechanics
Misconception #3: Heel Pain Always Indicates Plantar Fasciitis
Not every case of heel pain means you have plantar fasciitis. Although plantar fasciitis is common, other heel pain causes must also be considered, such as:
- Calcaneal Stress Fracture: A stress fracture can result from repetitive impact or increased activity, causing a deep, achy pain in the heel that worsens over time.
- Tarsal Tunnel Syndrome: This condition involves nerve compression near the medial malleolus (inner ankle bone), leading to tingling, burning, or numbness along with heel pain.
- Retrocalcaneal Bursitis and Haglund's Deformity ('Pump Bump'): Both conditions cause pain and inflammation at the back of the heel, often aggravated by tight or rigid shoes.
- Sever's Disease: Common in adolescents, Sever’s disease involves inflammation of the heel’s growth plate, especially during growth spurts.
Accurate diagnosing heel pain involves a thorough physical examination, detailed medical history, and sometimes imaging studies such as magnetic resonance imaging (MRI) or nerve conduction studies. Proper diagnosis ensures the correct treatment approach.
Misconception #4: Lifestyle Factors Don’t Influence Heel Pain
It's a myth that lifestyle choices have little to do with heel pain. In reality, how you care for your feet directly affects your risk of developing chronic heel pain. Important lifestyle and external factors include:
- Wearing supportive shoes with shock-absorbent soles and proper heel pads
- Regularly performing stretching exercises to improve flexibility in the plantar fascia and calf muscles
- Avoiding prolonged periods of standing or walking on hard surfaces without rest
- Maintaining a healthy weight reduces stress on the feet
- Early intervention with conservative treatments such as orthotic devices, night splints, ultrasound therapy, ice packs, and physical therapy to prevent chronic inflammation
Why Proper Diagnosis Matters for Lasting Heel Pain Relief
Heel pain can stem from a wide range of causes—some subtle, others more complex. That’s why at Paragon Podiatry, we begin every treatment plan with a thorough evaluation to uncover the true source of your discomfort, not just address the symptoms.
During your visit, our board-certified podiatrists will perform:
- A detailed physical examination to assess pain points, flexibility, and foot structure
- Gait analysis and review of your daily activities
- Imaging, when needed, to rule out issues like stress fractures or soft tissue injuries
- A discussion about your footwear, work routine, and lifestyle factors
Based on your diagnosis, we’ll build a personalized plan that may include:
- Radial Shockwave Therapy (RSW): A non-invasive technique that improves blood flow and accelerates healing for chronic plantar fasciitis
- Custom Orthotics & Shoe Inserts: Designed to support healthy biomechanics and reduce pressure on sensitive areas
- Targeted Physical Therapy: Exercises to build strength and flexibility in the foot and ankle
- Lifestyle Adjustments: Footwear upgrades, weight management guidance, and activity modifications
For more persistent cases, we may also explore corticosteroid injections or additional imaging like MRI to ensure no underlying issue is missed.
With a clear diagnosis and personalized care, our goal is to relieve your pain and restore lasting comfort.
Ready to Address the Root Cause of Your Heel Pain?
If you're tired of living with unresolved heel pain, it's time to get answers, not assumptions. Paragon Podiatry offers expert evaluation and treatment options designed around your specific diagnosis and goals.
Book online today to schedule your visit at our Manhattan, East Setauket, or Bronx office to get started with expert care for foot and ankle conditions. We're here to help you walk with confidence again.
