A common cause of heel pain is the heel spur, a bony growth under the heel bone. There are no visible features on the heel, but a deep painful spot can be found in or around the middle of the sole of the heel. Approximately 10% of the population may have heel spurs without any pain. Heel spurs result from strain on the muscles of the foot. This may result from biomechanical imbalance, a condition occurring in many people.
Both heel pain and heel spurs are frequently associated with an inflammation of the long bands of tissue that connect the heel and the ball of the foot. The inflammation of this arch area is called plantar fasciitis. The plantar fascia is an important support of the medial longitudinal arch and excessive pronation can cause chronic irritation of this structure, usually at its attachment to the calcaneus. The inflammation may be aggravated by shoes that lack appropriate support, especially in the arch area, and by the chronic irritation that sometimes accompanies an athletic lifestyle.
Pain is normally felt under the inside aspect of the heel. Characteristically, this occurs with the first few steps taken on arising in the morning. Walking on the toes or climbing stairs may make the pain worse.
Other causes of heel pain
- Excessive rolling in of the feet when walking.
- An inflamed bursa (bursitis), a small, irritated sack of fluid at the back of the heel.
- A Neuroma (a nerve growth).
- Other soft tissue growths.
- Heel bumps or 'pump-bumps', a bone enlargement at the back of the heel bone.
- Bruises or stress fractures to the heel bone.