Heel pain is one of the most common forms of foot pain in adults. It often occurs as a result of daily activities and exercise. The heel bone (calcaneus) is the largest bone in the foot and the heel is the first part of the foot to contact the ground during walking.
Normally, as the foot absorbs the weight of the body during walking, the arch area joint locking mechanism provides about 80% of the stability of the foot. The other 20% of biomechanical stability is provided by the plantar fascia and muscles, tendons, and ligaments.
Gait abnormalities can cause inflammation of the structures attached to the heel bone, resulting in heel pain. Inflammation of the plantar fascia, called plantar fasciitis, is the most common cause of heel pain. Many patients with plantar fasciitis have a heel spur on the front and bottom of their heel, but heel spurs do not cause pain. The common name is “heel spur” because it’s easier to pronounce than “plantar fasciitis” and podiatrists are able to point to the spur on an x-ray. Causes of heel pain include inadequate flexibility in the calf muscles, lack of arch support, being overweight, suddenly increasing activity, and spending too much time on the feet.
Sometimes, muscle strain and tension pull at the origin site on the bottom surface of the heel bone producing an inflammatory response that begins making new bone. This interim condition is called periostitis. The forming bone spur grows forward in the direction of this pulling. A heel spur can irritate nerves and cause pain.