Heel Pain
Heel pain is one of the most common reasons patients walk into our Research Blvd office. Most assume it's plantar fasciitis — and often it is — but heel pain has multiple possible causes, and the right treatment depends on an accurate diagnosis.
Symptoms
- Pain on the bottom of the heel, especially with first morning steps
- Pain along the back of the heel where the Achilles attaches
- Burning or tingling in the heel (nerve-related causes)
- Deep aching pain that worsens after prolonged activity
- Tenderness when pressing on the heel bone
- Swelling near the heel joint
Who Gets It
Heel pain affects runners, teachers and nurses who spend hours on hard floors, construction workers, and anyone who recently increased their activity level. It's also more common after 40, as the fat pad that cushions the heel thins with age. A runner with a stress fracture needs rest. A patient with nerve entrapment needs a different approach entirely.
Austin's trail running community — Brushy Creek, Barton Creek, the Violet Crown Trail — logs serious miles on uneven terrain. That's hard on heels. Dr. Wokasien has been diagnosing heel pain for 47 years and understands how to build a plan that matches your activity level, not just your symptoms.
Treatment
Most heel pain responds to conservative care:
- Custom orthotics to redistribute pressure
- Targeted stretching and strengthening exercises
- Activity modification — not elimination — keeping you moving while you heal
- Anti-inflammatory strategies
- Night splints for persistent cases
Surgery is rarely necessary for heel pain. When it is, Dr. Wokasien performs it at four Austin-area hospitals.
When to Call
If heel pain has persisted more than two weeks, or if it's affecting how you walk, call (512) 250-0444. Early treatment means faster recovery. Saturday mornings are available.
Frequently Asked Questions
How do I know if my heel pain is plantar fasciitis or something else?
Plantar fasciitis typically causes sharp pain on the bottom of the heel that's worst with the first morning steps and improves after walking. Achilles tendonitis is felt at the back of the heel. Stress fractures create a more localized, deep ache that worsens with activity. The only reliable way to know is an exam — Dr. Wokasien will determine the cause before recommending any treatment.
Do I need an X-ray for heel pain?
Often yes. X-rays can identify heel spurs, stress fractures, and bone changes that aren't visible from the outside. Dr. Wokasien uses imaging to confirm the diagnosis and rule out structural problems before building a treatment plan.
What are heel spurs, and are they the problem?
Heel spurs are calcium deposits on the underside of the heel bone, visible on X-ray. They're often found in plantar fasciitis patients, but the spur usually isn't the pain source — the inflamed soft tissue is. Treating the underlying inflammation typically resolves symptoms even when a spur is present.
Can I walk and exercise with heel pain?
Depends on the cause. Some activities are fine with modification; others will make things worse. Running through stress fracture pain, for example, can cause a complete break. Dr. Wokasien builds activity plans that keep you moving within safe parameters while the underlying issue heals.
How long before my heel feels better?
Mild plantar fasciitis caught early often improves in 4-6 weeks. Chronic cases, stress fractures, or nerve entrapment take longer. Starting treatment early is the most reliable way to shorten recovery. Waiting typically extends it.
Are night splints worth trying?
For plantar fasciitis specifically, yes. Night splints keep the plantar fascia gently stretched overnight, which reduces that sharp first-step pain in the morning. They're not comfortable to sleep in, but most patients find them effective for stubborn cases.
When is surgery an option for heel pain?
Surgery is a last resort — considered only after 6-12 months of consistent conservative treatment hasn't provided relief. The type of surgery depends on the diagnosis. Dr. Wokasien will discuss realistic expectations and recovery before recommending any procedure.