From the Guidelines
When describing calcaneal pain during a medical assessment, it is essential to provide specific details about the pain's location, quality, intensity, timing, aggravating and alleviating factors, and functional impact, as this comprehensive description helps clinicians differentiate between common causes of heel pain, leading to more accurate diagnosis and appropriate treatment planning, as recommended by the American College of Radiology in 2020 1. To achieve this, start by identifying the exact location of pain, such as the heel pad, posterior heel, medial or lateral aspects of the calcaneus, and characterize the pain quality, including sharp, dull, burning, or throbbing sensations. Rate the pain intensity on a scale of 0-10 and describe when it occurs, including morning, after activity, or at rest. Note what makes the pain worse, such as standing, walking, or specific shoes, and what provides relief, including rest, ice, or specific positions. Explain how the pain affects daily activities and mobility, and include relevant history, such as recent injuries, changes in activity level, or previous foot problems. Also, mention any associated symptoms like swelling, redness, or stiffness, as these details can help guide the diagnostic process and treatment planning, according to the American College of Foot and Ankle Surgeons in 2002 1. Key considerations include differentiating between common causes of heel pain, such as plantar fasciitis, Achilles tendinopathy, calcaneal stress fractures, or fat pad atrophy, and using radiography as the initial imaging study, as recommended by the American College of Radiology in 2020 1. Some important points to consider when describing calcaneal pain include:
- Location of pain
- Quality of pain
- Intensity of pain
- Timing of pain
- Aggravating and alleviating factors
- Functional impact
- Associated symptoms
- Relevant history By providing a comprehensive description of calcaneal pain, clinicians can develop an accurate diagnosis and effective treatment plan, ultimately improving patient outcomes and quality of life, as supported by the American College of Radiology in 2020 1.
From the Research
Describing Calcanea Pain on Medical Assessment
To describe calcanea pain on medical assessment, consider the following points:
- The location of the pain: calcanea pain is typically located on the underside of the heel, near the attachment of the plantar fascia to the medial tubercle of the tuberosity of the calcaneus 2
- The characteristics of the pain: plantar fasciitis, a common cause of calcanea pain, is often described as a sharp, stabbing, or burning pain in the heel, which may radiate to the arch of the foot 3
- The severity of the pain: the pain can be severe enough to limit daily activities, and may be worse after periods of rest or inactivity 4
- The presence of any associated symptoms: such as swelling, redness, or warmth in the affected area 5
Common Causes of Calcanea Pain
Some common causes of calcanea pain include:
- Plantar fasciitis: inflammation of the plantar fascia, which can cause pain and stiffness in the heel and arch of the foot 3, 4
- Achilles tendinopathy: inflammation of the Achilles tendon, which can cause pain and stiffness in the back of the heel 3
- Infracalcaneal heel pain: a condition characterized by pain on the underside of the heel, which can be caused by a variety of factors, including plantar fasciitis and Achilles tendinopathy 6
Diagnostic Tools and Treatment Options
Diagnostic tools and treatment options for calcanea pain may include:
- Physical examination and medical history: to determine the underlying cause of the pain and develop an appropriate treatment plan 6
- Imaging studies: such as X-rays or ultrasound, to rule out other causes of pain and assess the severity of the condition 2
- Conservative treatments: such as stretching exercises, orthotics, and corticosteroid injections, which can be effective in reducing pain and improving function 3, 4, 5