There are many different reasons why a heel becomes painful, and a thorough examination is required before a diagnosis can be made.

However, one of the most common problems associated with heel pain is known as plantar fasciitis with or without spurring. There is a long band of tissue that attaches to the front part of the heel bone to the ball of the foot. It's called Plantar fascia. Sometimes this fascia  becomes stretched beyond its normal limits, resulting in pain. It is then termed Plantar fasciitis. When the stretching is so severe the plantar fascia can pull bone away from the front aspect of the heel causing the formation of a spur. This translates to pain and tenderness felt directly under the heel.  Pain increases after a period of bed rest and when the affected person stands after sitting for short periods.

It is more frequent in men than women in their middle ages, although it can affect athletes as well.

Treatment consists of removing weight away from the plantar fascia. Again, orthotic therapy is the best option to reduce the pain. If this fails, injections of cortisone into the painful heel should be considered. Generally though, orthotic therapy provides great relief from this painful condition.