The common causes of heel pain are trauma, metatarsal tendonitis, gout, and other factors related to atrophy of the heel bone fat pad. 1. Trauma: The pain is caused by injury or fracture of soft tissues around the heel, such as ligament, tendon, joint capsule or even heel bone fracture, due to violence during walking or sports. 2. Metatarsal tendonitis: Inflammation of the metatarsal tendon membrane, which is aseptic inflammation of the soft tissues and leads to heel pain, commonly seen in long term walking, sports injuries, heavy weight, and high arches and flat feet. 3. Gout: It is usually caused by high concentration of uric acid in the blood, leading to the formation of uric acid crystals deposited in the joints, most commonly in the first metatarsophalangeal joint. The deposited crystals lead to inflammation in the joint area, which results in pain. 4. Others: In addition, heel pain can be caused by atrophy of the heel bone fat pad, as well as rheumatoid arthritis, which causes bone destruction in the foot. More causes of long-term heel pain also include aseptic necrosis of the heel bone and bone tumors and other rare diseases, you should go to the hospital to find out the cause, symptomatic treatment.