The most common cause of pain on the bottom of the heel (or sometimes the arch) is Plantar fasciitis. The plantar fascia is the thick band of tissue in the bottom of the foot that attaches from the heel to the base of the toes. The primary function of the plantar fascia is to help to support the arch of the foot. Damage to the plantar fascia can be caused by overuse from exercise or work activities, improper shoes, and/or the structure of the foot itself. Small tears can begin to occur in the fascia, which results in pain and inflammation that we call “plantar fasciitis". The pain is usually the most severe when you first get up in the morning or after resting.
There is sometimes confusion about the words used to describe plantar fasciitis. You may hear people talk about “heel spurs” or “bone spurs” on the heels. No matter what you call it, the causes, the condition itself, and the treatment are the same.
Fortunately, plantar fasciitis is a very treatable condition and almost never requires surgery or extended downtime. Some people with plantar fasciitis actually do have a “spur” or bone growth on the heel bone, but it is definitely not necessary to remove the spur in order to get better.
Other causes of pain on the bottom of the heel – Pain on the bottom of the heel is not always plantar fasciitis. The heel pad can be bruised or you can even develop a stress fracture. Children who develop pain on the bottom of the heel may have a problem with the growth plate of their heel bone.
Most causes of pain on the bottom of the heel can be managed with conservative, non-surgical treatment. However, getting the relief you need depends on getting treatment started early on in the course of your condition. Pain that is neglected or ignored is going to be that much more difficult to manage.