Sharp Heel Pain in The Foot Diagnosis Guide

Sharp Heel Pain in the Foot Diagnosis Guide – This guide follow the Foot Surgeons Guidelines for diagnosing your pain!


1 Major and Many Less Likely Causes:

Make sure that you have the major cause, and this treatment is for you!

The Major Cause:


1)Mechanical Heel Pain

The major cause of heel pain is mechanical. This means that there was no injury or disease process. This means that poor shoes, weight or tight muscles have been causing you to stand and walk improperly for many years leading to the eventual overuse of your foot ligaments!


More likely mechanical heel pain if:

  • Lack of stretching.
  • Tight ankles, hamstrings, hips or back.
  • Heeled shoes or any raised shoes.
  • Obesity.
  • Out of shape.
  • Prior injury altering the way you walk.

Less likely mechanical heel pain if:

  • Radiating numbness burning and tingling (more likely a nerve problem)
  • Decreased or absent normal joint range of motion- especially ankle dorsiflexion (likely arthritis)
  • Presence of hyperesthesia or dysthesias (nerve problem)
  • Decreased fat pad or fat pad atrophy (fat pad contusion)
  • If you suffered and injury (traumatic injury)
  • The heel went from feeling great to feeling awful in a short period of time.


These conditions lead to “weakened” ligaments that are not used to standing all day or walking long distances.  This leads to pain the morning upon and after periods of rest, but as you walk around the pain usually decreases.

If this is you- Go Back to the Treatment Guide:

Treatment Guide



The Less Likely Causes:

If you suspect that your heel pain is not caused by mechanical causes, then your best bet is to go see your podiatrist at this point.



These can occur as a result of compression of nerves along the inside of your ankle leading to the foot.


  • Radiating pain.
  • Sharp and shooting pain.
  • Numbness in your feet



This is as a result of arthritis in the ankle or the subtalar joint (a joint in the heel). This can also give the impression of radiating heel pain.


  • Likely if you are suffering from bilateral plantar fasciitis.
  • History of rheumatoid arthritis.
  • History of Psoriasis.
  • History of ankylosing spondylitis.
  • History of any other inflammatory arthritis.




– If you landed on your heel previously and it has led to aching pain, if you have been running heavily and your heel starts to hurt more after activity, if the pain has onset heavily one day after not hurting before.


  • Prior injury.
  • Prior severe pain.
  • Pain that appeared acutely.


4)Calcaneal Stress Fracture.

Stress Fractures due to overuse and pressure on the heel bone (the calcaneus).


  • Pain gets worse the more you walk on it.
  • Especially barefoot on a hard surface.
  • Just started heavy standing or exercise.


5)Heel Pad Contusion.

deep bruising pain in the middle of the heel. This can lead to sore and aching pain.


  • Prior soft tissue injury.
  • Swelling and bruising of the heel.


6)Achilles Tendinitis

The Back of the Heel, not the bottom.


  • Pain in the morning.
  • Pain in the back of the heel.
  • No inciting injury.