Nagging Pain at the Back of Your Heel?
Back of Heel Pain: Common Causes, Symptoms, and Lasting Relief
Pain in the back of your heel can make every step feel like a challenge. Whether it’s a dull ache or a sharp, stabbing sensation, this type of heel pain is often caused by conditions like Achilles tendinitis, bursitis, or Haglund’s deformity. Identifying the underlying issue is key to effective treatment and long-term recovery. In this guide, we’ll walk you through the potential causes, symptoms to watch for, and the best ways to treat back of heel pain so you can get back on your feet—comfortably.
Back Of Heel Pain Causes, Symptoms & Best Home Treatment
Back of heel pain [walking or running] The most common causes: #1) Achilles Tendonitis, #2) Heel Spurs #3) Retrocalcaneal Bursitis & #4)Haglund’s Bump!
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- Back of the heel pain can be improved with a few simple treatment changes.
- We are foot doctors & we see this problem get better almost every day.
- The goal is to solve this problem without medication or surgery if possible.
So, let’s GO!

Persistent heel pain isn’t something you should ignore. Our foot specialists at Michigan Foot Doctors provide expert diagnosis and tailored treatment plans to help you find fast, lasting relief. Book your consultation today.
What Causes Back of the Heel Pain & Best Treatment Video
- This video goes over what causes the back of the heel pain.
- It then goes over the BEST back of the heel pain treatment options!
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6 Best Back of Heel Pain Causes, Symptoms & Treatment
Back of heel pain is more common than most people think—and it can quickly interfere with your daily life, from walking the dog to climbing stairs. The discomfort can range from mild stiffness to sharp, stabbing pain that worsens over time. To help you understand what might be causing the issue and how to treat it, here are the 6 most common causes of back of heel pain, along with their symptoms and treatment options.
1. Achilles Tendinitis
Cause:
Overuse or strain on the Achilles tendon, often due to running, jumping, or wearing improper footwear.
Symptoms:
- Pain and stiffness along the back of the heel
- Swelling near the tendon
- Worsening discomfort with activity
Treatment:
- Rest and ice
- Stretching and strengthening exercises
- Physical therapy
- Orthotic inserts
- In severe cases, surgical intervention
2. Retrocalcaneal Bursitis
Cause:
Inflammation of the bursa (fluid-filled sac) between the Achilles tendon and the heel bone, usually due to repetitive stress or tight shoes.
Symptoms:
- Deep pain and swelling at the back of the heel
- Pain increases with pressure from shoes
- Redness and warmth in the area
Treatment:
- Anti-inflammatory medications
- Switching to open-backed or supportive shoes
- Ice therapy
- Corticosteroid injections (in chronic cases)
3. Haglund’s Deformity (“Pump Bump”)
Cause:
A bony enlargement on the back of the heel, often caused by pressure from stiff shoes (like pumps or cleats).
Symptoms:
- Noticeable bump on the heel
- Pain and swelling at the back of the foot
- Redness or callus formation
Treatment:
- Wearing soft-backed or open-heel shoes
- Heel pads or lifts
- Anti-inflammatories
- Surgery in severe or persistent cases
4. Achilles Tendon Rupture
Cause:
A partial or complete tear of the Achilles tendon, often caused by sudden or intense physical activity.
Symptoms:
- Sudden sharp pain at the back of the ankle
- A “pop” sound at the time of injury
- Difficulty walking or pushing off the foot
Treatment:
- Immediate medical attention
- Immobilization with a cast or boot
- Surgery followed by physical therapy for full rupture
5. Sever’s Disease (Children & Teens)
Cause:
Growth plate inflammation in the heel, typically affecting active children during growth spurts.
Symptoms:
- Pain at the back of the heel, especially after sports
- Limping or walking on toes
- Tenderness when the heel is squeezed
Treatment:
Rest and activity modification
- Heel cups or cushioned shoes
- Ice and anti-inflammatory meds
- Physical therapy if needed
6. Bone Spurs
Cause:
Excess bone growth on the heel, often associated with chronic inflammation or pressure.
Symptoms:
- Stiffness and sharp pain when walking
- Bony protrusion at the back of the heel
- Pain worsens with certain shoes
Treatment:
- Footwear changes
- Orthotics or custom insoles
- Physical therapy
- Surgery for severe or persistent pain
Say Goodbye to Back of Heel Pain
You don’t have to live with discomfort every time you walk. Our team is here to help identify the cause of your heel pain and offer real solutions. Schedule your visit now and take the first step toward pain-free movement.
Back Of Heel Pain Overview:
- This is most commonly related to Achilles tendinitis, but this can lead to heel spurs, bone problems, and even bursa rubbing.
- We will recommend some great treatment options to get you feeling better almost immediately!
Causes:
There is 4 very common back of heel pain causes:
- Achilles Tendinitis
- Bone Spurs
- Retrocalcaneal Bursitis
- A Hagland’s Bump.
Why do these problems happen?
- The underlying cause of all of these is your Achilles pulling out due to too much stress, but at the same time, it can irritate against the back of your heel.
1. Achilles Heel Pain
- The Achilles tendon inserts your calf muscles into the back heel of the foot.
- It is the strongest tendon in the body. It can lift your entire body!
- It is responsible for pushing off during running or walking.
- Overuse is widespread in runners and jumpers.
- It can even be overused in people who stand or walk all day!


2. Bone Spur On Back Of Heel
- This is caused by chronic Achilles heel pain.
- As the Achilles pulls on the heel, it will tear and bleed microscopically.
- Over years and decades, this blood will calcify, which leads to a permanent back of heel spur.
- The inflammation and swelling cause the majority of the symptoms.
- The only permanent way to remove the calcification is surgery.
- If severe enough, it can cause Achilles Rupture!
Bone Spur On Back Of Heel Symptoms
- This is usually associated with chronic Achilles pain.
- Like above, Back of heel pain in the morning is common.
- You can feel a bump on the back of your heel.
- There can be redness and swelling.
- Sharp pain in the back of the heel is from nerve irritation.
- If you treat the inflammation, the nerve pain will get better quickly.

Home Treatment Options:

3. Bursitis Back Heel Pain
- The bursa is a low friction fluid sack.
- It allows the Achilles tendon to glide against the skin and the bone.
- If the bursa becomes inflamed, this can increase friction and cause pain.
- This will also lead to Achilles tendinitis.
- Symptoms and treatment are similar to Achilles heel pain.
Bursitis Back Heel Pain Symptoms
- Almost identical to Achilles heel pain.
- Back of heel pain in the morning is very common.
- Morning or after rest, pain is the major indicator.
- The morning pain will get better within 15-20 minutes of motion.
- There can be redness and swelling.
- Pain in the back of the foot above the heel.
- Sharp pain in the back of the heel is from nerve irritation.
- If you treat the inflammation, the nerve pain will get better quickly.
4. Hagland’s Bump
- A Hagland’s bump is an increase in heel bone prominence.
- This larger heel bone can compress against the back of the shoe.
- This is most common in people with a high arch foot.
- Prevalent in 20-30-year-old females who wear high heels.

Hagland’s Bump Symptoms
- Redness and swelling at the back of the heel.
- No problem standing on tippy toes.
- If you do have problems standing on your tippy-toes, suspect Achilles tendinitis.
- Achilles tendinitis is also pain in the back of the foot above the heel.
- This is directly on the back of the heel.
- Sharp pain in the back of the heel is possible if there is nerve compression.
- This can cause numbness, burning, or tingling.
Also, Consider:
For more information about the back of heel pain, visit Bursitis of the heel.
Other Causes Of Heel Pain:
Plantar Fasciitis:
- This is the most common source of heel and arch pain.
- It is worse in the morning & better with a massage.
- This Includes heel spur treatment.

Bottom Of The Heel Pain:
- Bottom of the foot pain at the heel is most commonly by plantar fasciitis & heel spurs.
- You can also get a stress fracture, fat pad withering, bruising and more!

Achilles tendon-bone spur is at the back of the heel where the Achilles tendon inserts.
Foot Fat Pad Atrophy:
- If it feels like you do not have any fat pad cushion in your heel.
Heel Stress Fracture:
- This gradually onsets in high activity people starting a new activity.
- It presents over days and weeks as aching deep heel pain.
Posterior Tibial Nerve Entrapment:
- The posterior tibial nerve runs along the back and inside of the ankle.
- You will feel numbness, burning, and tingling.
- Bottom of the foot pain radiating along the inside back of the ankle can be a tarsal tunnel.
- Consider this if you have numbness, burning, and tingling.
- This happens after a long-running or a big fall.
- This is a deep contusion after stepping on a stone.
Back Of Heel Pain Running Or Walking:
- Back of the heel pain after running or after walking is very common.
- This is most commonly due to Achilles heel pain.
- The Achilles tendon is responsible for pushing off.
- Running and walking require 1,000’s cycles of this motion.
- This leads to overuse and inflammation!
- Strongly consider Achilles Heel Pain & Bursitis Heel Pain below.
If the pain is at the bottom of the heel or arch: Consider Arch Pain.


Achilles Tendon & Back of Heel Pain
Back of the Heel Pain Causes:
Back of the heel pain is most commonly caused by the Achilles tendon and back of the calcaneus damage.
The most common causes of back heel pain are:
- Fat pad atrophy can lead to calcaneus bone pain.
- Insertional Achilles tendinitis pain.
- Achilles tendinitis 2-6 cm above the heel bone.
- An Achilles tendon strain or rupture.
- Nerve impingement or entrapment in the heel.
- Achilles tendinosis.
- Back of the heel spur pain.
- Achilles tendon bursitis.
- Plantar fasciitis.
Achilles Tendonitis Symptoms:
- Achilles tendonitis symptoms can be a pain in the morning when you first wake up.
- Pain when trying to bend the foot up as the Achilles tendon inserts into the back of the heel.
- Worsening inflammation and tenderness while standing and walking for long periods of time.
- Improvement when wearing good shoes, good orthotics, and supportive sandals.
Back Of The Heel Pain Treatment:

Best Back of Heel Pain Treatment:
- There are usually two phases to treating back of the heel pain.
- The two phases of treatment include controlling the acute inflammation and correcting the biomechanics, which led to the problem in the first place.
- If the tendons and ligaments are inflamed, they are almost frozen in place and cannot function properly.
- Once the inflammation is decreased, we need to correct the biomechanical causes to ensure that the Achilles tendon can never become overworked and inflamed again!
- This doesn’t matter whether it’s The back of the heel spur, fat pad atrophy, insertional Achilles tendinitis, Achilles tendinitis, or even Achilles tendinosis.
- If you do have an Achilles tendon rupture or tear, seeing podiatrist care immediately.
Achilles Tendon Natural Treatment:
Massage & Ice Products:
- Ice is an excellent option that can be safe for almost everyone.
- There is some debate about whether icing is worth doing, but this can help limit the need for medications and keep your options open for chronic pain.
- This works great for your arch, less for the ball of the foot.
- Manual massage on the Achilles tendon & calf muscle is a natural treatment that can also be considered physical therapy for your back of the heel pain.
- This works well for calf muscle pain and Achilles tendon pain.
- The more muscle and ligament tissue there is, the better ice will work there.






Menthol Based Gels:
- Biofreeze is one of our favorites.
- These gels have been studied to work 2x as long as ice.
- This works great for the ball of the foot.
- This can be very effective for pain relief, but this can decrease inflammation in the calf muscle and Achilles tendon.








Massage Sticks:
- These can work great for loosening your muscles.
- This allows less tightness and pressure onto the plantar fascia and heel.
- This is very effective for the arch, the gastrocnemius, calf muscle, and the hamstring and thigh muscles.
- This also works very well for the gluteus muscles if you are having butt cheek or hip pain.
- The massage stick can break up lumps in your Achilles tendon and heel pain.






Remove the Achilles tendon tightness.
- The key is to prevent future pain stress and trauma to the Achilles tendon muscle.
- This means keeping you active while keeping stress off of your Achilles tendon. This will prevent future re-injury and the development of plantar fasciitis.
- If you can get rid of the pain and swelling, this will let you start walking normally.
- If you can walk normally, the vast majority of your pain should gradually start to go away.
- The best way to ensure that your plantar fascia, foot, and ankle ligaments are not overworked is to support them.
- The best way to support them is to use great orthotics and great shoes.
- Some people may also need to rely on supportive ankle braces and other supportive modalities.
Best Shoes for Back of Heel Pain:
- Getting a great supportive pair of Achilles tendonitis shoes will ensure that there is pressure removed from the heel and plantar fascia region.
- This is especially important if you have plantar fasciitis, heel spur pain, or Achilles tendonitis as well.
- Consider Achilles tendonitis shoes combined with a good supportive orthotic for best pain relief!
- The following link will show you what our favorites are.
Best Achilles Tendonitis Insoles:
- These are our recommended orthotics for Achilles tendonitis.
- Custom orthotics can work very well, but they should not be the first line of treatment due to the cost.
- There are different types of different shoes.
- Women’s shoes usually need a less bulky orthotic but allow for less correction.
- A full-length orthotic requires a running shoe, boot, or comfortable walking/dress shoe.
- We recommend doing everything you can to get a good supportive shoe that can fit a full-length orthotic.
- A further home remedy tip for Achilles tendonitis pain is cutting out a hole where the nodule uses scissors or a knife. Be careful and start with a very low-cost orthotic.
Click this link for the best podiatrist recommended orthotics!
Best Full Length Achilles tendonitis Orthotics:
- These will only work in wider shoes or a good supportive running shoe.
- This will not work in sandals, flats, or most women’s dress shoes.








Best Dress Shoe Achilles tendonitisOrthotics:
- These are a great choice for dress orthotics.






Best 3/4 Length Achilles tendonitis Orthotics:
- These are great options for women’s dress shoes and thinner shoes.
- These are not the most supportive pair of orthotics.


Get A Great Dynamic Stretch:
- It is possible to stretch on your own, but these products can also really help!
- This will take pressure off of the ball of your foot.
- This form of the back of the heel pain physical therapy breaks up the scar tissue.
- We personally prefer this method of stretching.








Get A Great Static Stretch:
- These devices are great for stretching while you are resting.
- This is an excellent Achilles tendonitis physical therapy that you can do at home.
- This will also help take pressure off of the ball of your foot.
- This works great for plantar fasciitis.
- The static night splint can use it while watching TV or at night time.






Best Heel Compression Brace:
- A good compression brace can stabilize your foot from turning outward.
- This prevents your foot from pronation.
- The pronated foot will turn your foot outward, in your foot will rub on the outside of the shoe.
- This has solved their pain for many of her patients and is very comfortable to wear inside your shoe.
- This solves both pain and outward pronation for a relatively low cost.




Best Heel Stability Brace:
- The stability brace goes a little bit further than the compression brace to stop your foot from turning out.
- This takes the pressure off of your heel and plantar fascia.
- At the same time, this is a little bit bulkier and does not affect every shoe.
- We find people are a little bit happier trying the compression brace before the stability brace.






Severe Achilles tendonitis Pain:
- If you think you might have a broken heel, a calcaneal stress fracture, or something of similar severity, these products might help!
- Always remember to see a foot and ankle specialist like a podiatrist if you have plantar fasciitis or more severe pain!
Plantar Fascia Tear, Broken Heel Bone, Achilles Tendon Tear:
- If you have a traumatic injury such as a torn plantar fascia ligament, calcaneus stress fracture, heel fracture, or insertional Achilles tendon injury: consider protecting your foot!
- The best way to do this is, of course, to see your podiatrist and get evaluated with an x-ray, ultrasound, and potentially even an MRI or CT scan.
- If you cannot do so, it may benefit you to be in a cast, fractured boot, or even keep the weight off of it with a rolling knee scooter or other protective devices.
- We as podiatrists frequently take patients off work for very long periods of time when they suffer a traumatic injury. Unfortunately, there is no other way around us in labor jobs.
- If you have a sit-down job, there are ways to get people back to work quicker, but this can be not easy otherwise.
Heel Injury Boot Treatment:
- There are pros and cons to using a boot to treat your heel injury. The Pros are that your injured heel will hopefully have a chance to heal gradually! If you are immobilized too long, the cons are that you will gradually become stiff and overworked to your other leg.
- Our favorite fracture boots and their supplies:








Offloading and Scooter treatment:
- These are favorite knee scooters and walking devices.
- If your Achilles tendonitis pain is severe, offloading can be very effective until the pain calms down.








Frequently Asked Questions About Back of Heel Pain
Common causes include Achilles tendinitis, retrocalcaneal bursitis, and Haglund’s deformity.
Achilles tendinitis usually causes pain, stiffness, and swelling in the back of the heel or lower calf, especially after activity.
No, plantar fasciitis typically affects the bottom of the heel, not the back.
Yes, shoes with poor heel support or stiff backs can irritate the Achilles tendon or bursae.
If the pain persists for more than a week, worsens, or affects your ability to walk, you should see a specialist.
Treatments may include rest, physical therapy, orthotics, anti-inflammatory medication, or in some cases, surgery.
It can be, especially if the Achilles tendon is tight after sleep or long periods of inactivity.
Yes, specific stretches for the Achilles tendon and calf muscles can relieve tension and pain.
With proper care, mild cases can improve in a few weeks. More severe conditions may take several months.