How can you tell if you've got a heel fracture instead of plain heel pain?

X-ray: Only way to be sure is x-ray. Depending on history and exam, doctor will order to differentiate between soft tissue and bone as pain source. Common cause of non-traumatic pain is plantar fasciitis, which can be make pretty awful first few steps of the morning.

Heel pain: Clinical evaluation mostly but sometimes x rays and even MRI necessary to diagnose and differentiate.

X-rays: A standard series of plain film radiographs is the best diagnostic tool to determine if heel pain could be caused by an underlying process such as a fracture.

X-ray: Have it evaluated by a professional and get the appropriate treatment.