Plantar fasciitis, inflammation of a tissue band extending from heel to toes, is a common cause of bottom heel pain, states the American College of Foot and Ankle Surgeons. Other causes include heel spurs and stone bruises from stepping on hard objects, explains the American Orthopaedic Foot & Ankle Society.
When the plantar fascia becomes inflamed due to over-stressing the foot, pain is initially experienced under the heel, explains the AOFAS. The pain is worse in the morning and after exercise of the legs and feet. Although the pain may begin as a mild discomfort, failure to treat the condition can result in chronic plantar fasciitis that significantly diminishes physical activity. If plantar fasciitis continues for an extended period, calcium deposits called heel spurs develop, in which the fascia band connects to the heel bone, causing additional heel pain. Initial treatment for heel spurs is identical to that for plantar fasciitis, and surgical removal of spurs is warranted only in chronic cases.
Treatment is multifaceted, as described by the ACFAS. Activity changes should include initial reduced activity to rest the foot, regular stretches of the foot and calf to increase flexibility and ease pain, and avoidance of going barefoot to reduce strain on the plantar fascia. Modifications to shoes is recommended to provide good arch support. Icing the heel for 20 minutes several times each day can reduce inflammation. The use of orthotic devices inserted into shoes is also a common treatment.