Right heel pain is most commonly caused by plantar fasciitis, a condition where the thick band of tissue running along the bottom of your foot becomes irritated from repeated stress. But the location of your pain, when it shows up, and how it feels can point to several different causes, some of which need different treatment. Here’s how to narrow down what’s going on.
Pain on the Bottom of the Heel
If your pain is concentrated on the underside of your heel, especially near the front edge, plantar fasciitis is the most likely explanation. The plantar fascia is a tough strip of connective tissue that runs from your heel bone to your toes, supporting the arch of your foot like a bowstring. Repeated tension on this tissue causes small tears, which trigger inflammation and pain. The hallmark symptom is sharp pain with your first few steps after waking up or after sitting for a long time. The tissue tightens while you’re off your feet, and those initial steps re-stretch it.
Standing for long hours, a sudden increase in activity, tight calf muscles, and carrying extra body weight all raise your risk. Flat feet and high arches can also contribute because both change how force distributes across the sole. The good news: up to 90% of cases resolve with nonsurgical treatment, though it takes patience. A typical recovery plan spans 6 to 12 weeks of consistent stretching, icing, and supportive footwear.
Pain at the Back of the Heel
If the pain is behind your heel rather than underneath it, the Achilles tendon is the more likely culprit. This tendon connects your calf muscles to your heel bone, and overuse, especially from ramping up running or walking too quickly, can cause it to become painful and stiff. You’ll typically notice it most during or after exercise, and the area may feel tender to the touch.
Achilles tendon problems tend to come on gradually, starting as a mild ache after activity and worsening over weeks if you push through it. Unlike plantar fasciitis, the pain is usually worst during movement rather than with those first morning steps, though some morning stiffness is common with both.
A Dull Ache That Builds Over Weeks
Heel pain that developed slowly over days to weeks and feels deep inside the bone could indicate a calcaneal stress fracture. This is a tiny crack in the heel bone itself, usually from repetitive impact like running on hard surfaces or a sudden jump in training volume. One distinguishing feature: squeezing the sides of your heel with your hand reproduces the pain. With plantar fasciitis, squeezing the sides of the heel typically doesn’t hurt because the irritation is on the bottom surface.
Stress fractures won’t show up on a standard X-ray in the early stages. An MRI or bone scan is usually needed to confirm the diagnosis. If you suspect a stress fracture, reducing weight-bearing activity early prevents it from becoming a full break.
Heel Pain That’s Worse at Night
Most mechanical heel pain improves with rest. If yours gets worse at night or produces sharp, radiating sensations, a nerve issue may be involved. One common form is entrapment of a small nerve branch on the inner side of the heel. This produces a burning or shooting pain that can spread outward across the heel, sometimes accompanied by tingling or numbness. People with flat or overpronated feet are more susceptible because the foot structure puts extra pressure on the nerve.
Nerve-related heel pain is frequently misdiagnosed as plantar fasciitis because the location overlaps. The key differences are the quality of the pain (burning or electric rather than a dull ache) and the fact that it often worsens with rest rather than improving.
Loss of the Heel’s Natural Cushion
Your heel has a built-in shock absorber: a fat pad roughly 1 to 2 centimeters thick made of fatty tissue and elastic fibers. Over time, this pad can thin out or lose its elasticity, leaving the heel bone closer to the ground with less protection. The result is a bruised, achy feeling that’s worst on hard surfaces and when walking barefoot.
Age is the biggest factor, but regularly walking without supportive shoes, carrying extra weight, and high-impact activities all accelerate the process. Unlike plantar fasciitis, the pain from fat pad atrophy tends to be more centralized directly under the heel bone and doesn’t have that distinctive “worst with the first step” pattern. The tissue feels hard or thin when you press on it.
Heel Spurs Are Rarely the Problem
If you’ve been told you have a heel spur, it’s worth knowing that the spur itself probably isn’t causing your pain. About 15% of the general population has heel spurs visible on X-rays with zero symptoms. Less than 5% of people with spurs ever experience pain from them. Spurs form as a response to chronic tension on the heel bone, not as an independent source of trouble. The real issue is almost always the soft tissue around the spur, whether that’s the plantar fascia, the fat pad, or a nearby nerve.
Stretches That Reduce Heel Tension
Tight calves are one of the biggest modifiable factors in heel pain because they increase the pulling force on the plantar fascia with every step. A few targeted stretches, done consistently, can make a significant difference over weeks.
Wall calf stretch: Stand facing a wall with your hands on it for support. Step your right foot back, keeping that knee straight and your heel flat on the ground. Bend your front knee until you feel a stretch through the back of your right calf. Hold for 45 seconds, repeat 2 to 3 times, and aim for 4 to 6 sessions throughout the day.
Step stretch: Stand on a step with just the ball of your right foot on the edge. Let your heel slowly drop below the level of the step until you feel a pull in your calf. Same timing: 45 seconds, 2 to 3 reps, several times daily.
Seated toe extension: Cross your right leg over your left and grab your toes. Pull them back toward your shin to stretch the arch. While holding for 10 seconds, use your other hand to massage along the arch. Repeat 10 times, once or twice a day.
Frozen bottle roll: Place a frozen water bottle under your foot and roll it back and forth for 3 to 5 minutes, twice daily. This combines a gentle stretch with icing to reduce inflammation.
Footwear and Support Options
Going barefoot on hard floors is one of the most common aggravators. Shoes with firm arch support and a slightly cushioned heel make an immediate difference for many people. If your heel pain is related to fat pad thinning, heel cups or gel inserts add a layer of shock absorption that the natural pad no longer provides. These are inexpensive and available over the counter.
For plantar fasciitis specifically, over-the-counter arch supports are a reasonable first step. They work by redistributing pressure away from the heel. If pain persists beyond 6 to 12 weeks of consistent stretching and supportive footwear, custom orthotics molded to your foot can provide more targeted correction. Night splints, which hold your foot in a flexed position while you sleep, are another option if morning pain is your primary complaint. A 1 to 3 month trial is typical.
Signs That Need Prompt Attention
Most heel pain responds to time and conservative care, but certain symptoms warrant faster evaluation. Severe pain and swelling that appeared suddenly after an injury could mean a fracture or tendon rupture. Inability to bend your foot downward, stand on your toes, or walk normally suggests structural damage beyond simple inflammation. Heel pain paired with fever, or numbness and tingling in the heel, points to possible infection or significant nerve involvement.