Factors that can contribute to heel pain include a heel bone cyst, nerve entrapment, arthritis, tendinitis and stress fracture, states Cleveland Clinic. Most adults experience heel pain due to plantar fasciitis, which occurs when the plantar fascia on the bottom of the foot becomes swollen. The plantar fascia is a group of tissue running from the heel to the toes.
Being obese, regularly wearing nonsupportive footwear on uneven surfaces for long hours, and having a flat foot or an extremely high-arched foot are factors that increase the risk of plantar fasciitis, notes Cleveland Clinic. Pain below the heel that aggravates after waking up in the morning or sitting for a prolonged period is a common symptom of the condition. The pain usually subsides after walking briefly, but it worsens after a few months if left untreated.
Pain below the heel possibly indicates stone bruise, in which the thick pad on the underside of the heel becomes bruised when a person steps on a rock or another hard object, explains the American Orthopaedic Foot & Ankle Society. Pain behind the heel likely results from retrocalcaneal bursitis, which is an inflammation of the part of the foot where the Achilles tendon slips in the heel bone. Treatment options for heel pain involve addressing the underlying cause, performing stretching exercises, taking pain medication or using open-back shoes.