Upper and plantar heel pains are differentiated from one another. Plantar heel pain is usually caused by plantar fasciitis. A heel spur is a side effect and is not related to the cause of the symptoms. Upper heel pain is mostly caused by tendonitis of the Achilles tendon or Haglund exostosis. Only through an exact diagnosis is an adequate and usually conservative therapy possible. If the conservative therapy should fail, it is nevertheless important to clarify the indication for surgery to prevent the problems from becoming chronic.