The back part of the human foot below the ankle is known as the heel. It is the posterior end of the foot, based on the projection of one bone, called the calcaneus or simply the heel bone, behind articulation of the bones of the lower leg. Many of us suffer with heel pain from time to time. When we think it has gone, somehow it reappears. Here Rachel Ross, LiveScience.com, reflects on causes, symptoms and treatments associated with heel pain:

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“If the first few steps you take in the morning are painful, you might be experiencing plantar fasciitis. It's one of the most common causes of foot pain, with 2 million to 3 million patients seeking medical treatment each year, said Dr. Michael Greaser, an orthopedic surgeon and assistant professor at McGovern Medical School at The University of Texas Health Science Center at Houston. Many of the patients typically seek treatment after having months or years of heel pain. There are most likely many others who have plantar fasciitis that never seek treatment.

The stabbing pain that is felt is caused by inflammation of a band of tissue known as the plantar fascia that connects the heel bone to the toes. The pain is normally localized near the heel but can be felt anywhere along the plantar fascia ligament, according to Dr. Dominic Catanese, professor and chief of podiatric surgery at Montefiore Medical Center at Albert Einstein College of Medicine in New York.

The pain tends to be worse first thing in the morning and after long periods of sitting or standing. When there is no weight put on the foot, the ligament shortens and tightens, Catanese said. Then when the patient stands, the sudden stretching of the plantar fascia with the added weight may result in pain. Usually the pain subsides after a few minutes of walking and stretching.

Causes and diagnosis

There are many reasons why one might develop plantar fasciitis, according to the American Orthopedic Foot & Ankle Society. Some of these factors include being overweight, being on your feet for extended periods and wearing shoes with inadequate support. In addition, impact exercises such as running, tight calf muscles that limit ankle mobility, flat feet or high arches, excessive pronation (when the foot rolls severely inward when walking) or wearing high heels on a regular basis can be aggravating factors.

Heel spurs are commonly thought to cause plantar fasciitis, but the opposite is more likely to be true, Greaser said. A heel spur is the bony outgrowth on the edge of the heel that's often the result plantar fasciitis, but it's rarely the cause of heel pain.”

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