A variety of soft tissue, osseous, and systemic disorders can cause heel pain. Narrowing the differential diagnosis begins with a history and physical examination of the lower extremity to pinpoint the anatomic origin of the heel pain. The most common cause of heel pain in adults is plantar fasciitis.ain and numbness often radiate to the plantar heel and, in some cases, extend even to the distal sole and toes. View/Print Figure. Figure 2. Medial view of the ankle illustrating the course of the posterior tibial nerve through the tarsal tunnel.