Burning Heel Pain: Causes, Treatments, and When to See a Doctor

Intense, burning heel pain can stop you in your tracks, making every step excruciating. While there are many common benign causes behind burning heel discomfort, more serious conditions can also be at fault.

In this comprehensive guide, we’ll cover the full range of potential causes, home treatment options, when to see a doctor, and the medical diagnostic and treatment process.

By the end, you’ll have a thorough understanding of how to find relief if your heels are burning up. Let’s get to the bottom of this painful problem.

Anatomy of the Heel

To understand why heel pain occurs, it helps to be familiar with basic heel anatomy. Here are the key structures:

• Heel bone (calcaneus) – The hard bone protruding from the rear of the foot. Provides support when walking or running.
• Plantar fascia – Thick connective tissue band extending from heel to toes. Helps support the arch. Prone to inflammation.
• Fat padding – Shock absorbing fat around the heel bone. Loss of padding causes pain.
• Achilles tendon – Attaches calf muscles to heel bone. Tightness or tears cause heel discomfort.
• Nerves – Branching nerves between the heel and arch are compressed in plantar fasciitis.
• Blood vessels – Arteries and veins running to the skin and heel tissues can be impacted.

With so many delicate structures packed into a small area, it’s no wonder heel pain is common. Next, let’s cover the wide range of potential causes.

What Causes Burning Heel Pain?

A variety of conditions can cause burning, stabbing heel discomfort:

• Plantar fasciitis – Inflammation of plantar fascia tissue. Most common cause.
• Achilles tendinitis – Irritated and inflamed Achilles tendon.
• Arthritis – Joint damage causes bone spur irritation.
• Calcaneal stress fracture – Overuse injury to heel bone.
• Fat pad atrophy – Loss of protective fat pad padding.
• Tarsal tunnel syndrome – Pinched nerve causes burning pain.
• Baxter’s neuritis – Inflamed nerve between toes and heel.
• Bursitis – Swollen fluid-filled bursa sac becomes irritated.
• Bone bruise – Direct blow to heel bone causes pain.
• Gout – Uric acid crystals in the joint cause inflammation.
• Nerve damage – Diabetes and other conditions can damage nerves.

Less common sources of burning heel discomfort include cysts, tumors, heel spurs, and plantar fibromatosis. Now let’s go through each cause in more detail.

Most Common Causes of Burning Heels

These conditions make up the majority of burning heel pain cases:

Plantar Fasciitis

Inflammation and microtearing of the plantar fascia ligament from repetitive strain or injury. The sharpest pain is often felt with the first morning steps.

Achilles Tendinitis

Overuse leads to inflammation, scarring and pain in the Achilles tendon attaching to the back of the heel. Pain worsens when pushing off steps.

Arthritis

Osteoarthritis joint damage in the foot causes bone spur growth and compression of heel tissue. Pain worse after rest that eases somewhat with movement.

Heel Stress Fractures

Repeated impact like running long distances can cause tiny fractures in the heel bone. Occurs in active people suddenly increasing activity levels.

Getting to the accurate diagnosis is key to proper treatment. Now let’s go over some self-care tips.

Home Remedies for Burning Heel Treatment

For general heel pain not caused by fractures, tumors or other serious conditions, these at-home measures can provide relief:

Rest

Avoid activities that worsen pain like high impact exercise. Don’t push through pain. Give heels time to heal.

Ice

Applying ice packs or cold compresses for 10-15 minutes several times a day can reduce inflammation. Always wrap ice packs to prevent frostbite.

Compression

The mild compression of a heel sleeve, sock or sports tape provides support and reduces swelling.

Elevation

Resting feet above heart level helps decrease inflammation related swelling and discomfort in the damaged tissue.

OTC Medication

Anti-inflammatory over-the-counter drugs like ibuprofen or naproxen sodium may temporarily relieve pain.

Stretching

Gently stretching the plantar fascia and Achilles helps maintain flexibility. Avoid over-stretching which can worsen injury.

Orthotics

Supportive, cushioned inserts reduce strain on the plantar fascia and protect the heel by evenly distributing pressure. Wear in all shoes.

For chronic long term cases, your podiatrist may recommend night splints, injections, shockwave therapy or PRP injections to promote healing. When home care doesn’t provide lasting relief, it’s time to see a foot doctor.

Signs You Should See a Podiatrist

Schedule an appointment promptly if:

• Burning heel pain persists longer than 2 weeks
• Swelling, redness, or visible bruising appears
• Both heels are affected, not just one side
• You develop numbness or tingling in the feet
• Pain disrupts sleep or activities of daily living
• Home treatment and rest does not relieve symptoms
• The heel area looks deformed or misaligned

While most minor cases resolve with a little TLC, lingering or worsening discomfort warrants medical assessment to rule out serious causes or complications. Foot health issues are much easier to treat early on.

Podiatrist Diagnosis of Heel Pain

To get to the root cause of your burning heel discomfort, the podiatrist will:

• Ask questions about your symptoms, activity level, diet, health conditions, medications. Look for contributing factors.
• Examine your feet, heels, arches and ankles. Check for swelling, redness, bruising, or misalignment. Note areas of tenderness.
• Evaluate your gait to see if biomechanics might be contributing to strain.
• Order diagnostic testing such as x-rays, MRI, CT scan or ultrasound if needed to visualize soft tissue, bones, or rule out fractures.
• Discuss previous treatments tried and why pain persists.

Based on their findings, your podiatrist will determine the specific cause and best treatment plan. Most cases of heel pain are due to either plantar fasciitis or Achilles tendonitis. Let’s look closer at these two common culprits:

Plantar Fasciitis Explained

Inflammation of the plantar fascia ligament from repetitive overuse is the leading cause of burning heel pain. Here’s an overview:

What is it?

Microtears and inflammation in the thick connective tissue band (plantar fascia) that runs from heel bone to toes.

What does it feel like?

First steps after rest cause sharp stabbing pain in the heel or arch that then eases somewhat after warming up. Chronic discomfort walking or standing.

Risk Factors

Flat feet, high arches, sudden increases in activity, high impact exercise, excess weight, tight calf muscles.

Diagnosis

Podiatrist checks for specific tenderness in arch and heel. X-rays or ultrasound confirm.

Treatment Timeline

With proper care, symptoms start to resolve in as little as 2 weeks. Full recovery can take several months depending on severity.

Treatment Options

OTC orthotics, rest, ice, massage, stretching, night splints, medical-grade orthotics, anti-inflammatory medication, injections, shockwave therapy, PRP, surgery as a last resort.

Following doctor’s orders for rest, orthotics use and physical therapy stretches is key to prevent recurrence. Let’s compare to the other top cause of burning heels.

Achilles Tendinitis Explained

The Achilles tendon attaching the calf muscles to the heel bone becomes painfully inflamed and irritated due to overload and repetitive strain:

What is it?

Inflammation of the Achilles tendon where it inserts into the heel, caused by repetitive stress and strain.

What does it feel like?

Burning, stabbing pain centered in the back of the heel, worse when pushing off or up on toes, tenderness, stiffness, swelling, heat under skin.

Risk Factors

Tight calf muscles, increasing activity too quickly, high impact sports, hill running, shoes with inadequate heel cushioning.

Diagnosis

Podiatrist will check for pain pinpointing at the back of the heel on the tendon. MRI can confirm.

Treatment Timeline

With proper rest and care, pain may start improving within 2 weeks. Full recovery can take 3-6 months depending on severity.

Treatment Options

Rest, ice, OTC heel cushions/orthotics, gentle stretching and strengthening of calf muscles, medical orthotics, night braces, physical therapy, injections, shockwave therapy, PRP, surgery if other approaches fail.

Patience and allowing proper time for recovery is vital to prevent complications or recurrence. Now let’s look at other causes.

Other Causes of Heel Discomfort

In addition to the most common plantar fasciitis and Achilles tendinitis, burning, stabbing heel pain can also arise from:

Arthritis

Joint cartilage damage causes heel bone spur growth that irritates tissue with each step. Diagnosed via x-ray. Rest, orthotics, medication, injections, surgery options.

Tarsal Tunnel Syndrome

A pinched nerve between ankle and heel causes burning pain. Numbness or tingling in foot. Diagnosed with EMGs. Treated with braces, therapies, steroid injections, or surgery.

Heel Stress Fractures

Repeated high impact forces micro fractures in the heel bone. Confirmed via imaging. Requires cast and rest from activity to heal.

Fat Pad Atrophy

Loss of the shock absorbing fat pad under the heel bone. Orthotics provide padding. Fat grafting surgery can help.

Bone Bruises

Direct blow to the heel causes deep bone pain and tenderness. Ice, rest, compression, elevation helps.

Baxter’s Nerve Neuritis

Irritated nerve between the 4th and 5th toes causes burning in the heel. Rest, ice, shoe inserts provide relief.

Gout

Build up of uric acid crystals in the joint spaces can lead to intense bouts of burning pain. Treated with diet, medications, and lifestyle changes.

If pain persists, don’t ignore it. See a foot doctor who can get to the bottom of what’s causing your heel hurt.

Can Foot Nerve Damage Cause Heel Pain?

Yes, diabetes and other systemic conditions that cause nerve damage in the feet can certainly contribute to burning, piercing heel pain. Let’s look closer:

Peripheral Neuropathy

Nerve damage from diabetes is the most common cause. High blood sugar injures nerve fibers. The feet with their small nerves are especially vulnerable over time. Burning, tingling, numbness results. Treating the diabetes can help symptoms. Medications and supplements that calm nerve pathways may provide some pain relief as well.

Chemotherapy Induced

Certain chemotherapy drugs used to treat cancer can damage peripheral nerves. This results in burning, throbbing sensations often worse at night. Medications may provide mild pain relief but symptoms should slowly improve once chemotherapy treatment is complete.

Autoimmune Disorders

Diseases like lupus and rheumatoid arthritis where the immune system attacks healthy cells can in rare cases damage nerves leading to burning feet. Controlling the underlying autoimmune disease is key to relieving the nerve pain.

Vitamin Deficiencies

Lack of essential vitamins like B12, niacin, folate, Vitamin C and E can injure nerves over time. Addressing nutritional deficiencies and absorption issues helps reverse much of the nerve damage.

While sensitizing nerves isn’t the most common source of heel pain, the podiatrist will perform appropriate tests if nerve damage is suspected. Let’s look at when radiating heel pain signals a bigger issue.

When Heel Pain May Indicate Serious Health Conditions

While most heel pain stems from local foot conditions, radiating burning discomfort can reflect larger health problems. See your doctor promptly if your heel pain:

• Shoots down through the foot and up the leg
• Is accompanied by chest pain or breathing issues
• Spreads to the entire bottom and sides of the feet
• Is paired with vision issues or dizziness
• Is accompanied by abdominal discomfort
• Worsens significantly at night disrupting sleep
• Does not respond to 2 weeks of focused home treatment

These characteristics could reflect spinal issues like herniated discs, vascular concerns like blood clots, nerve compression, or rarely, multiple myeloma cancer.

Catching severe heel pain early helps address the underlying cause sooner for the best outlook. Now let’s look at the doctor’s visit.

Your First Podiatry Visit for Heel Pain

To get to the root of your heel symptoms, the initial foot doctor visit entails:

Medical History

Your podiatrist will ask in-depth questions about your health history, heel pain onset, risk factors, and past treatments tried.

Foot and Lower Limb Exam

The podiatrist will check range of motion, swelling, skin condition, circulation, areas of discomfort, and evaluate your gait looking for imbalance.

Diagnostic Testing

If the cause of heel pain is uncertain, tests like x-rays, MRI, EMG nerve conduction studies, ultrasound, CT and bloodwork help diagnose.

Treatment Plan Discussion

Based on findings, your podiatrist maps out an appropriate treatment plan tailored to your specific heel diagnosis and symptoms.

The right plan can get your burning, painful heels finally on the path to recovery with some patience. Now let’s look at treatment options.

Medical Treatments for Burning Heel Discomfort

Depending on exam and test findings, your podiatrist may recommend:

Prescription Orthotics

Custom orthotics help correct biomechanical imbalances exacerbating strain on plantar fascia and Achilles. Must be worn consistently.

Medications

Anti-inflammatory drugs, diclofenac gel, analgesics, and nerve pain medications can temporarily reduce inflammation and discomfort.

Physical Therapy

Stretching, massage, exercises, rest, modalities like ultrasound and iontophoresis help heal overuse damage and strengthen tissues.

Bracing

Night splints keep the plantar fascia and Achilles tendon stretched to prevent morning stiffness and pain.

Injections

Corticosteroid or PRP injections reduce localized inflammation and help kickstart healing.

Shockwave Therapy

Uses sound waves to stimulate healing in the injured plantar fascia and Achilles tissues. Multiple sessions often needed.

Surgery

Removal of painful bone spurs, damaged tissues or nerves done as a last resort if conservative treatments fail and function is impaired.

With a tailored treatment plan focused on the specific cause of your burning heel pain, you can finally find lasting relief. Talk to your doctor about a referral to podiatry.

When to See a Podiatrist vs Orthopedist

If you’re experiencing intense heel pain, should you see a podiatrist who specializes in feet or visit a general orthopedist? Here are some tips:

See a Podiatrist for

• Suspected plantar fasciitis
• Achilles tendonitis
• Fat pad atrophy
• Pinched foot nerves like tarsal tunnel syndrome
• Gout limited to the feet
• Numbness, burning, tingling isolated in the lower legs and feet

See an Orthopedist or Orthopedic Surgeon for

• Partial or complete Achilles tears
• Stress fractures
• Spinal issues radiating into the heel or feet
• Ankle arthritis or joint instability contributing to heel pain
• Vascular concerns like blood clots or poor circulation causing burning feet
• Metastatic cancer suspected in the feet or ankles

The right specialist will depend on your specific symptoms and diagnosis. Both can provide immense relief!

Gaining Relief from Burning Heel Discomfort

Dealing with constant burning, stabbing heel pain can feel agonizing. But with proper self-care, expert treatment, and a dose of patience for tissue healing, you can get back on your feet again.

Pay close attention to any symptoms affecting your quality of life and don’t delay seeing a foot specialist. Catching causes early increases your chances of swift recovery.

Working closely with your podiatrist provides the best outlook. Don’t give up until you find lasting relief! Here’s to pain-free feet.

Burning Heel Pain FAQs

Here are some quick answers to frequently asked questions about burning heel pain:

I hope these answers provide some guidance on addressing burning sensations in the heels and feet. The key is not ignoring discomfort that persists or worsens over 2 weeks.

Seek a full evaluation from a foot specialist to determine the underlying cause and optimal treatment plan. With the right approach, relief is within reach! Please let me know if you have any other burning heel questions.