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Heel pain or pain on the bottom of the foot could be caused
by common conditions such as plantar fasciitis or heel spur. The pain from such conditions is usually worse in the morning when getting up from bed or prolong period of rest.

Plantar fascia is a thick band of tissue on the bottom of the foot which connects the heel to the bones in the forefoot. Inflammation of this tissue causes pain on the bottom of the foot and heel pain 

This condition is more common in runners, obese people, and pregnant women. The treatment initially includes rest, reduce weight bearing activity, anti inflammatory medications, ice and stretching exercises. If the condition lasts for more than several months, a chronic scar tissue may form around the plantar fascia, causing severe, debilitating pain. In that case, a more aggressive course of treatment such as shockwave therapy or fasciotomy maybe indicated.

Heel spur is an excess deposit of calcium on or around the heel bone. Risk factors include poor fitting shoes, long distance runners, excess weight or obesity. Heel spur could be asymptomatic. In other cases, patients report a sensation of sharp, stabbing pain on the heels or bottom of the foot. A heel spur is diagnosed using X-ray or other imaging studies which show excess calcium deposit on or around the heel bone. Treatment includes rest, stretching, padded shoes and physical therapy.

In case of chronic pain, a surgical course of treatment for release of plantar fascia or removal of the bone spur maybe needed.

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