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Differential Diagnosis of Heel Pain



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Submitted 2009-12-23 21:07:12

Copyright (c) 2009 Michele Colon

Although plantar fasciitis has been in the news lately, it should be noted that there are many causes of heel pain. Many people jump to the conclusion that if they have heel pain, they must have plantar fasciitis. This is not always the case. Let's look at some other causes of heel pain.

The following medical conditions are some of the possible causes of heel pain:

Achilles tendinitis: an inflammation of the Achilles tendon which is triggered by overuse.

Arterial insufficiency: occurs when the amount of blood flowing through an artery is inadequate to oxygenate the tissueS. It can cause pain, muscle cramps, exacerbation of symptoms with activity, improvement of symptoms with rest, and paleness.

Arthritis-related enthesitis: an inflammation of the attachment of ligaments/tendons to bone due to arthritis. It causes heel pain and swelling.

Bone tumors: in the heel they are rare and generally benign. The pain typically starts as a dull, deep pain, quickly worsens, and is associated with swelling.

Calcaneal apophysitis (Sever's disease): a pain in the back of the heel which can be irritated with increased activity, especially jumping. It is common in active children between the ages of 8 and 14.

Heel pad fat atrophy: can occur in elderly patients and in patients who have received multiple steroid injections in the heel. The pain on the plantar aspect of the heel is diffuse, worsens with ambulation on hard surfaces, and is aggravated by hard-soled footwear.

Heel spur: an abnormal growth of bone on the calcaneus at ligamentous or tendinous attachments.

Jogger's foot (medial plantar neuropraxia): an entrapment of the medial plantar nerve in the foot. It is sometimes seen in long distance runners.

Nerve entrapment: a compression of a branch of the lateral plantar nerve which causes pain, numbness or tingling. It can be related to any type of swelling near the heel.

Plantar fasciitis: a painful inflammation of the plantar fascia, a fibrous band of tissue on the sole of the foot. It occurs when the fascia is overloaded or overstretched, causing small tears in the fibers, especially where the fascia meets the heel bone.

Plantar fascial rupture: a complete tear of the plantar fascia near or at its attachment to the calcaneus. There typically is a dull pain in the heel prior to the injury. Acute pain develops after jumping and landing on the foot or taking off quickly in a sprint. It can also occur after receiving steroid injections in the heel.

Pump bump (posterior calcaneal exostosis, or Haglund's deformity): an abnormal bony growth at the back of the heel. It is common in young women with long-term bursitis caused by pressure from shoes.

Reiter's syndrome: a disorder that causes a triad of symptoms: arthritis, conjunctivitis, and urerthritis. It is a disorder that causes inflammation throughout the body, particularly in parts of the spine and at other joints where tendons attach to bones.

Retrocalcaneal bursitis: inflammation of the bursa located in the posterior aspect of the heel bone. It can be related to structural deformities of the foot that cause an abnormal gait or to poorly fitting shoes.

Sciatica: a pain originating from a pinched sciatic nerve in the back that radiates down the back of the leg and into the heel. It may feel like burning, tingling, or numbness. The pain may worsen with sitting, at rest, or when lying down.

Stone bruise: an impact injury caused by stepping on a sharp object, usually while walking barefoot.

Stress fracture: can occur in the calcaneus, sometimes in long distance runners.

Tarsal tunnel syndrome: occurs when a large nerve in the back of the foot becomes entrapped or pinched. It is similar to carpal tunnel syndrome.

Article By : Michele Colon

Author Resource:- In this article, Dr. Colon discusses the various causes of heel pain in patients of all ages. To read some of Dr. Colon's other podiatric articles, visit her website at http://www.footdoc.moogo.com or her blog page at http://drcolon.blogspot.com/

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