Posterior Heel Pain [Causes, Symptoms & Best Treatment]
Posterior Heel Pain: 95% of the time, this is Achilles tendinitis, retrocalcaneal bursitis, or a back of the heel spur. Fix it FAST!
Posterior Heel Pain After Running & Walking Video
Posterior Heel Pain Causes & Symptoms

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.
Posterior Heel Pain Causes:
- The most common causes of posterior heel pain are 4 things!
- Click On The Titles For Treatment!
1)Achilles Heel Pain:
- This is almost always due to Achilles tendinitis.
- The Achilles tendon connects your calf to the back of the heel,
- It is the strongest tendon in the body.
- It is responsible for pushing off with your foot.
- Repetitive pushing off (usually in runners and basketball players) can lead to stress!
- This can happen to any athlete, even people who walk or stand for long periods of time!

Posterior Achilles Heel Pain Symptoms:
- This will hurt to stand on your tippy-toes.
- It will be painful at the back of the heel.
- There can be redness and swelling.
- It is worse in the morning and before activity but gets better with 15-20 mins of motion!
2)Posterior Heel Spur Or Calcification:
- This is a progressed stage of Achilles tendinitis.
- Eventually, the insertion of the Achilles can form bone.
- This infiltrates the Achilles tendon due to light bleeding that turns to bone.
Posterior Heel Spur Calcification Symptoms:
- Same as Achilles heel pain or tendonitis.
- Except now you can feel a posterior heel spur.

3)Bursitis Heel Pain:
- A bursa is a gel sack that decreases friction.
- This allows the Achilles tendon to glide against the bone and skin.
- If the bursa becomes irritated, it will swell and become inflamed.
- This is essentially the same as Achilles tendinitis.
Posterior Bursitis Heel Pain Symptoms:
- This will hurt to stand on your tippy-toes.
- It will be painful at the back of the heel.
- There can be redness and swelling.
- It is worse in the morning and before activity but gets better with 15-20 mins of motion!

4) Hagland’s Bump Posterior Heel Pain:
- This is an excess smooth bone at the back of the heel.
- This is just above the Achilles tendon insertion.
- This can rub against the back of the shoe and cause pain.
- It essentially impinges on the skin.
- This is more likely in high arched feet.
- Very likely in women with high heels.

Hagland’s Bump Posterior Heel Pain Symptoms:
- Can stand on tippy toes, unlike Achilles tendinitis, without pain.
- This feels like a giant lump of bone on the back of the heel.
- It is very noticeable.
- It will rub against the back of the shoe.
- It can cause numbness, burning, and tingling due to nerve impingement.
Posterior Heel Pain Running:
- Posterior heel pain after running is most commonly Achilles tendinitis!
- The second most common cause is posterior heel bursitis.
- Either way, they are both treated the same!
- So click on either one and start healing your posterior heel pain after running!

Best Heel Pain Products:
- There are usually two phases to treating plantar fasciitis 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 bio-mechanical causes to ensure that they can never become over worked and inflamed again!
- This doesn’t matter whether it’s plantar fasciitis, plantar fibroma, sore bottom of foot, or even Achilles tendon pain. Treatment is all roughly very similar.
Plantar Fasciitis or Achilles Tendonitis Inflammation:
Massage & Ice Products:
- Ice is the an excellent option that can be safe for almost everyone.
- There is some debate whether icing is worth doing, but for chronic pain this can help limit the need for medications and keep your options open.
- This works great for your arch, less for the ball of the foot.
- 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 bottom of the heel and Achilles tendon sore regions.








Massage Sticks:
- These can work great for loosening your muscles.
- This allows less tightness and pressure on the ball of your foot.
- This is very effective for the arch, the gastrocnemius or calf muscle and for the hamstring and thigh muscles.
- This also works very well for the gluteus muscles if you are having butt cheek or hip pain.






Remove the Plantar Fascia or Achilles Tendon Stress:
- The key is to prevent future pain.
- This means keeping you active while keeping stress off of your plantar fascia tendon. This will prevent future re-injury and 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.
The Best Heel Pain & Plantar Fasciitis Shoes:
- Getting a great supportive pair of shoes will make sure 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.
- Consider shoes combined with a good supportive orthotic for best pain relief!
- The following link will show you what our favorites are.
Best Heel Pain & Plantar Fasciitis Orthotics:
- These are our recommended orthotics for plantar fasciitis.
- Custom orthotics can work very well, but they should not be a first line of treatment.
- There are different types for 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.
- This is the best way to maximize your orthotics for great results.
Click this link for the best podiatrist recommended orthotics!
Best Full Length 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 Orthotics:
- These are a great choice for dress orthotics.






Best 3/4 Length 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.
- We personally prefer this method of stretching.








Get A Great Static Stretch:
- These devices are great for stretching while you are resting.
- This will also help take pressure off of the ball of your foot.
- This works great for plantar fasciitis.
- It can be used 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 pronated.
- Pronated foot will turn your foot outward in your foot will rub on the outside of the shoe.
- For many of her patients this has solved their pain 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:
- Stability brace goes little bit further than the compression brace to stop your foot from turning out.
- This takes 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 little bit happier trying the compression brace before the stability brace.






Heel Injury:
- 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 are having 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 are unable to 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 period 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 very difficult otherwise.
Heel Injury Boot Treatment:
- There are pros and cons to using a boot to treat your heel injury. If you are immobilized too long the cons are that you will gradually become stiff and overworked to your other leg. The Pros are that you injured heel will hopefully have a chance to gradually heal!
- Our favorite fracture boots and their supplies:








Offloading and Scooter treatment:
- These are favorite knee scooters and walking devices:




FAQ: Posterior Heel Pain – Causes, Diagnosis, and Effective Treatment Options
Posterior heel pain refers to discomfort or soreness at the back of the heel, where the Achilles tendon attaches to the heel bone. It can result from overuse, inflammation, or structural issues.
Common causes include Achilles tendinitis, retrocalcaneal bursitis, Haglund’s deformity, calcaneal apophysitis (in children), or even poorly fitting shoes that rub against the heel.
Symptoms often include swelling, tenderness at the back of the heel, stiffness, and pain that worsens with activity, especially after periods of rest or when wearing certain types of shoes.
A doctor or podiatrist will perform a physical exam, ask about your symptoms and activity level, and may order X-rays, ultrasound, or MRI to identify inflammation, bony spurs, or tendon damage.
Achilles tendinitis involves inflammation of the Achilles tendon, while retrocalcaneal bursitis is inflammation of the bursa (fluid-filled sac) between the tendon and the heel bone. Both can cause posterior heel pain but may require slightly different treatments.
Treatment may include rest, ice, anti-inflammatory medications, heel lifts, proper footwear, stretching exercises, and sometimes physical therapy. Severe cases may require immobilization or even surgery.
Yes. High-heeled shoes, tight shoes, or stiff-backed footwear can increase pressure and irritation at the heel, contributing to or worsening the condition. Supportive, cushioned shoes are recommended.
Recovery depends on the cause and severity, but mild to moderate cases typically improve within a few weeks with proper care. Chronic or more severe cases may take several months and require a combination of therapies.