Pain in the upper inch of the heel can be caused by Achilles tendonitis, bursitis, osteophytes and other factors. 1. Achilles tendonitis: the Achilles tendon can produce strain injury after repeated strenuous stretching, mainly manifested as pain, swelling and stiffness at the top of the heel, and in severe cases, it is impossible to walk on the ground. 2. Bursitis: the Achilles tendon stop and the surrounding soft tissues, by the heel bone and the back side of the shoe repeatedly rubbing and squeezing for a long time, can form synovitis. In the early stage of synovitis, a mildly hardened erythema may occur above the heel, which may be caused by pressure pain. When the inflamed synovium increases, a painful red lump may appear above the Achilles tendon. 3. Osteomalacia: osteophytes at the heel bone, the proliferation of the bone can stimulate the surrounding soft tissues, long-term stimulation can lead to the formation of local aseptic inflammation, which can cause pressure and pain at the top of the heel. When there is pressure pain on the top of the heel, you should consult a doctor in time, under the guidance of a specialist to actively carry out appropriate treatment, which will help to alleviate the pain and other uncomfortable symptoms as soon as possible.