 Other causes of heel pain are excessive weight which may add extra stress on the feet, ankles, knees and hips. Poorly- made or minimally- cushioned shoes, worn out shoes, flip-flops, constant walking on hard, concrete surfaces. Heel pain can also be contributed to a sudden increase in walking or running in patients who are seasoned athletes as well as those person just starting an exercise program.
Additionally, heel pain can be contributed to a condition call Haglund’s deformity or in layman’s term, “pump bump.” The bump is actually a boney abnormality on the back of the heel where the Achilles tendon is attached. This pathology is seen mostly in women and can become quite painful while wearing shoes. Most patients respond well to conservative treatment, however, when this fails to relieve pain, surgical removal of the boney abnormality may be considered.
 Heel pain can also be due to various systemic disorders such as arthritis. Types of arthritic conditions include rheumatoid, gouty or psoriatic arthritis and Reiter’s syndrome. Patients may complain of painful swelling and erythema about the heel. For a complete diagnosis of these ailments, radiographs, and/or nuclear imaging and clinical laboratory findings are used to give a more complete diagnosis.
There are various treatment options for heel pain including rest, pain medications, injections, physical therapy, and stretching. Wearing shoes with arch support and/or custom orthotics can help.
Additional treatments for heel pain include ESWT (Extra Corporeal Shockwave Therapy) and cryotherapy. Most patients respond well to the above mentioned noninvasive therapies. For recalcitrant heel pain that fail to resolve with non surgical treatment, conventional surgery may be the next option. | 
