Why Your Heel Pain Gets Worse at Night and How to Find Relief

The clock reads 2:30 a.m. and you're wide awake again. That familiar ache in your heel throbs with each position change, making it impossible to find comfort. What started as a minor morning discomfort has evolved into a nightly ordeal that steals precious hours of rest. The good news is Canyon Foot + Ankle Specialists will help you identify the causes of nocturnal heel pain and provide relief with some of our innovative treatment solutions.

What’s the Science Behind Nighttime Heel Pain?

Many patients visiting our Burley and Twin Falls offices are puzzled by a common concern: why does heel pain that feels manageable during daily activities become so intense at bedtime? The answer lies in how your body's systems shift gears when transitioning from active daytime mode to nighttime recovery.

Inflammatory Response Cycles

Your body's natural inflammatory response follows a circadian rhythm, with certain markers peaking during nighttime hours. This biological process often intensifies existing heel pain conditions such as Achilles tendinitis or plantar fasciitis—just two of the many conditions that frequently cause nagging heel pain.

Blood Flow Changes During Rest

During the day, gravity helps promote circulation in your feet. When horizontal, your cardiovascular system must work differently to maintain proper blood flow, potentially leading to increased swelling and pressure in inflamed tissues.

Temperature and Pain Sensitivity

When we’re asleep, core and peripheral temperatures decline, which could hypothetically make tendons, ligaments, and fascia—especially in the heel region—somewhat more sensitive or less compliant. Cooler conditions reduce blood flow, stiffen connective tissues, and increase the viscosity of joint or interstitial fluids, all of which might heighten existing inflammation or discomfort. 

Daily Stress Accumulation

Muscle tension patterns shift throughout the day. By evening, accumulated stress from walking, standing, and daily activities causes muscle tightening that affects heel positioning and pressure distribution.

What Foot and Ankle Conditions Cause Nocturnal Heel Pain?

At Canyon Foot & Ankle Specialists, our skilled podiatrists know every underlying condition creates a distinct pain signature that becomes more pronounced during rest periods. Here are just a few problems our patients experience. 

Plantar Fasciitis

This condition ranks as the leading cause of nocturnal heel pain. It involves inflammation of the fascia, a thick band of tissue connecting your heel bone to your toes. It naturally contracts during rest periods, creating morning stiffness and nighttime discomfort that interrupts sleep cycles.

Heel Spurs

These calcium deposits develop over time in response to chronic plantar fascia strain. While heel spurs themselves may not cause pain, the surrounding soft tissue inflammation might intensify during periods of inactivity.

Achilles Tendinitis

This condition creates a different but equally disruptive pain pattern. Since it affects the large tendon connecting your calf muscles to your heel bone, different positions in bed often place additional tension on an already inflamed area, creating sharp or burning sensations.

Tarsal Tunnel Syndrome

When the tibial nerve—located within the tarsal tunnel behind your ankle—is compressed during sleep, many people feel burning or tingling in their heel. Tarsal tunnel syndrome often develops due to flat feet or fallen arches, ankle swelling, or complications from diabetes or arthritis. 

Stress Fractures

Usually caused by repetitive impact activities or sudden increases in exercise intensity, these microscopic bone cracks create deep, aching pain. Some people report that foot fracture discomfort—even if they don’t know that’s the problem—worsens when lying down, potentially because reduced movement, changes in blood flow, and circadian effects on pain sensitivity make the injury more perceptible. 

Potential Solutions for Better Sleep

The most effective remedies for nocturnal heel pain use simple techniques that work with your body's natural healing processes to reduce inflammation and maintain tissue flexibility.

• Elevation techniques. Raising your feet 6–8 inches above heart level helps reduce swelling and improve circulation. Use pillows or a foam wedge to maintain comfortable positioning throughout the night.
• Ice therapy before bedtime. Fill a water bottle and freeze it, then roll it under your heel for 10–15 minutes while watching television or reading. This simple technique may numb pain receptors.
• Pre-sleep stretching routines. Gentle calf stretches, towel stretches for the plantar fascia, and ankle mobility exercises prevent tissue contractions that contribute to morning stiffness and nighttime pain.
• Night splints for continuous stretching. In some cases, our Idaho podiatrists recommend these devices to maintain your foot in a slightly flexed position during sleep, preventing the tissue shortening that occurs naturally during rest periods.
• Proper sleep positioning. Supportive pillows between your knees improve overall alignment and reduce heel pressure points. Some people find relief by sleeping with their feet hanging slightly off the bed's edge.
• Anti-inflammatory medications. Over-the-counter options taken according to package directions may also help manage nighttime pain patterns. However, we advise that you consult with your primary care provider before starting any medication regimen, especially if you take other prescriptions.

When to Seek Professional Care From Canyon Foot & Ankle Specialists

Persistent nocturnal heel pain causing sleep disruption for more than two weeks warrants evaluation by one of our skilled podiatrists. Early intervention frequently prevents minor heel pain from developing into chronic conditions requiring more extensive care. Our podiatry team uses advanced diagnostic techniques to identify the specific cause of your nighttime discomfort.

Depending on your condition, our innovative treatment options for heel pain include custom orthotics, physical therapy protocols, injection therapies, and advanced treatments like shockwave therapy. We’ll help you turn restless nights into restful slumber.