Heel pain is usually caused by acute or chronic inflammation of the plantar fascia, a ligament-like structure located on the bottom of the foot. Inflammation of the plantar fascia (plantar fascitis) can be caused by a heel spur (pointed to by arrow in picture below) or by gout, arthritis, obesity, and other local and systemic diseases. Heel pain can frequently be treated by such conservative methods as orthotic foot supports, cortisone injections, oral anti-inflammatory medications, and weight loss, if indicated. A new conservative treatment called EPAT (shock wave therapy) may also alleviate the pain without surgery. When conservative treatment fails, surgical intervention may be necessary. In most cases, the surgical treatment can be performed minimal invasive in the modern facilities of Laser Foot Surgery Centers.