The most common cause of heel pain is plantar fasciitis. It is usually caused by a biomechanical imbalance resulting in tension along the plantar fascia. The diagnosis is typically based on the history and the finding of localized tenderness. Treatment consists of medial arch support, anti-inflammatory medications, ice massage and stretching. Corticosteroid injections and casting may also be tried. Surgical fasciotomy should be reserved for use in patients in whom conservative measures have failed despite correction of biomechanical abnormalities. Heel pain may also have a neurologic, traumatic or systemic origin.