Heel pain is one of the most common foot complaints among adults over 40, yet it is also one of the most misunderstood. Many people experience a sharp or stabbing sensation in the heel when they take their first steps in the morning. The pain may ease after a few minutes of walking, creating the impression that the problem is minor or temporary.
In reality, this “morning heel pain” pattern often signals a deeper issue related to tissue recovery and repeated mechanical stress. Clinics that focus on conservative pain treatment and physiotherapy approaches increasingly encounter patients who ignored early symptoms, hoping the pain would disappear on its own. An overview of such physiotherapy-based pain management methods is available on the main English page here:
For readers who prefer information in Russian, there is also a main page available in Russian language, explaining the same approach to chronic pain treatment and physiotherapy methods:
(Russian-language page)
The reason heel pain is often worst in the morning lies in how the foot behaves during rest. Overnight, tissues such as the plantar fascia and surrounding connective structures are not under load. Areas that have been irritated during the day cool down, stiffen, and lose elasticity.
When a person stands up after sleep, these stiff tissues are suddenly stretched and forced to bear weight. This abrupt loading is what causes the sharp pain during the first steps. As movement continues, blood flow increases, tissues warm up, and flexibility improves — which explains why the pain often decreases after walking for a short time.
However, this improvement is temporary and does not mean the tissue has healed.
Many people believe that if pain decreases after movement, the body is recovering. In heel pain cases, this assumption is often wrong. Movement masks stiffness but does not repair micro-damage in the tissue.
Throughout the day, the heel continues to absorb stress from walking, standing, and everyday activities. By evening, discomfort often returns. Over weeks or months, this cycle becomes consistent: pain after rest, partial relief with activity, and renewed irritation later in the day.
This is how heel pain gradually becomes chronic.
Unlike muscle soreness, heel pain typically does not improve with simple rest. Complete unloading of the foot is unrealistic for most people. Even normal daily activity can be enough to keep the tissue in a constant state of irritation.
Several factors contribute to this: