Heel Pain vs. Arch Pain vs. Nerve Pain: How to Tell the Difference

Foot pain is rarely “just foot pain.” One of the most common things we hear from patients at Restore Foot and Ankle Specialists is:
“I don’t know how to explain it—it just hurts.”

That’s understandable. Pain in the foot can feel similar at first, but where the pain is located and how it feels tells us a lot about what’s actually going on. Heel pain, arch pain, and nerve pain may overlap, but they come from very different causes—and treating the wrong one can delay healing.

Let’s break down how to recognize the difference.

Heel Pain: Pain Where Your Foot Meets the Ground

What Heel Pain Typically Feels Like

Heel pain is most often felt:

• On the bottom of the heel

• At the back of the heel

• Deep and sharp, or achy and sore

A classic sign is pain that’s worst with the first steps in the morning or after sitting for a long period.

Common Causes of Heel Pain

The most common cause we see is plantar fasciitis, but heel pain may also be related to:

• Heel spurs

• Achilles tendon irritation

• Bursitis

• Stress fractures

Heel pain usually develops gradually and worsens over time if left untreated.

Why Heel Pain Happens

Heel pain often results from:

• Poor arch support

• Tight calves or Achilles tendon

• Prolonged standing

• Unsupportive footwear

• Changes in activity level

Arch Pain: When the Middle of the Foot Is the Problem

What Arch Pain Feels Like

Arch pain is felt:

• Along the inside or bottom of the foot

• In the middle portion between heel and toes

• As a stretching, pulling, or burning ache

It may worsen during activity and linger afterward.

Common Causes of Arch Pain

Arch pain can be linked to:

• Overuse or strain

• Flat feet or collapsing arches

• Posterior tibial tendon dysfunction

• Poor foot mechanics

• Inadequate footwear

Arch pain often indicates instability or overloading of the foot’s support system.

Why Arch Pain Matters

If ignored, arch pain can lead to:

• Progressive flat foot deformity

• Heel pain

• Ankle, knee, or hip problems

Early treatment is key to preventing long-term structural changes.

Nerve Pain: Pain That Feels Different—and Often Confusing

What Nerve Pain Feels Like

Nerve pain is usually described as:

• Burning

• Tingling

• Sharp or electric

• Shooting pain

• Numbness

It may come and go, worsen at night, or travel into the toes.

Common Causes of Nerve Pain in the Foot

We commonly diagnose nerve pain related to:

• Peripheral neuropathy

• Nerve entrapment

• Tarsal tunnel syndrome

• Diabetes-related nerve damage

• Spinal or systemic conditions

Unlike heel or arch pain, nerve pain isn’t always triggered by activity.

Why Nerve Pain Is Often Misdiagnosed

Because nerve pain doesn’t always show up on X-rays and can feel unpredictable, many patients are told “everything looks normal.” Without proper evaluation, nerve pain can persist or worsen over time.

Key Differences at a Glance

Heel Pain

• Worst with first steps

• Located at heel

• Often mechanical or inflammatory

Arch Pain

• Felt through midfoot

• Related to support and stability

• Worsens with activity

Nerve Pain

• Burning, tingling, numb

• Can occur at rest

• Often neurological in origin

Why Proper Diagnosis Is So Important

Treating nerve pain like plantar fasciitis—or arch pain like heel pain—can lead to:

• Delayed healing

• Chronic discomfort

• Worsening symptoms

• Unnecessary frustration

At Restore Foot and Ankle Specialists, we focus on identifying the exact source of pain, not just the location.

How We Diagnose Foot Pain

Our evaluation may include:

• Detailed history and symptom pattern

• Physical and biomechanical examination

• Gait analysis

• Imaging when needed

• Neurological assessment

This allows us to create a targeted, personalized treatment plan.

When to See a Podiatrist

You should schedule an evaluation if:

• Foot pain lasts more than a few days

• Pain keeps returning

• You feel burning, tingling, or numbness

• Pain interferes with walking or daily life

• Home treatments aren’t helping

The Bottom Line

Heel pain, arch pain, and nerve pain may feel similar—but they are not the same condition. Understanding the difference is the first step toward lasting relief.

At Restore Foot and Ankle Specialists, our goal is to help you move comfortably, confidently, and pain-free by treating the root cause—not just the symptom.

If your foot pain doesn’t feel “normal,” it’s time to get answers. Contact our office today with Dr. Gireesh Reddy or Dr. Sirisha Pokala by calling (469) 573-3427 or by booking an appointment online.