Risk factors for developing heel swelling and pain include repeated or prolonged walking and running, wearing tight or worn out shoes, having a flat feet or high arches, and certain activities that result in trauma or injury. Repeated trauma to the heel can lead to the formation of abnormal bone growths (heel spurs), which causes chronic heel pain. Ankle and heel pain are usually associated with tightness of the Achilles tendon due to shortening of the calf muscles. This is also common in high heel pain, which usually occurs among women.

Heel pain symptoms may vary, depending on the cause. For example, morning heel pain is usually associated with plantar fasciitis. With Achilles tendonitis, heel pain increases after running or climbing stairs. Gout heel pain may also occur if the inflammation and swelling affect the ankle.