What causes sharp heel pain with the first steps in the morning?

The wording of this question already contains the best clue: the pain arrives with the first steps. Readers in Itasca who describe it that way are using almost the same phrase the published sources use.

What the sources describe

NIH PMC describes symptoms that usually start as intermittent medial plantar heel pain after a long period of rest, typically with the first steps in the morning, or after a long walk.

AAFP adds the second half of the pattern, saying patients usually describe pain in the heel on taking the first several steps in the morning, with the symptoms lessening as walking continues.

What the pattern does and does not say

Put together, the description has a trigger (rest or a long walk), a place (the heel) and a course (worst at first, then easing). That is a description of the pain, not a diagnosis. A page cannot tell you which condition is behind it, and a clinician examining the heel can.

If plantar fasciitis has already been named as the cause, these studies and reviews of its treatment are a place to read further: focused shock wave therapy trial, physiotherapy systematic review, shock wave meta-analysis of RCTs and long term shock wave results in amateur runners.

What to confirm, and with whom

Tell your clinician exactly when the pain starts and when it eases. Those two details are what the sources above rely on, so give them in your own words and ask what diagnosis they point to.

The clause people skip

"Lessening as walking continues" is not the same as gone. Easing after a few steps does not mean the heel has stopped asking for an answer.