The most common cause of heel pain is plantar fasciitis, typified by the presence of a heel spur (a plantar fasciitis) on the front and bottom of their heel. The heel spur does not actually cause pain but is a clear indication on an x-ray of long term inflammation which caused calcium deposits at the point where the plantar fascia inserts into the heel. Pain invariably derives from either inadequate flexibility in the calf muscles, lack of arch support, being overweight, suddenly increasing activity, and spending too much time on the feet.
Symptoms include a dull persistent ache with episodes of a sharp pain in the centre of the heel or on the inside margin of the heel. Pain is often most severe on first putting weight on the heel in the morning and after rest and is aggravated by prolonged weight bearing and thin soled shoes.
The condition may result from or be aggravated by obesity, weight increase during pregnancy, sudden rise in walking or sporting activity or excessive flattening of the arch on weight bearing, possibly associated with walking abnormalities. Arthritis can also cause heel pain.
Treatment is best achieved with arch support.