Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: June 16, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Heel Pain

Single Most Likely Diagnosis

  • Plantar Fasciitis: This is the most common cause of heel pain, especially when it occurs on the bottom of the foot and may extend to the midfoot. It is often associated with inflammation of the plantar fascia, a band of tissue that supports the arch of the foot. The pain typically worsens with the first steps after waking up and may improve with activity but worsen as the day progresses.

Other Likely Diagnoses

  • Fat Pad Atrophy: This condition involves the loss of the fatty tissue under the heel, leading to pain and discomfort, especially when walking barefoot or on hard surfaces.
  • Plantar Fibromatosis: A condition characterized by the growth of benign tumors (fibromas) on the plantar fascia, which can cause pain and discomfort on the bottom of the foot.
  • Tarsal Tunnel Syndrome: Compression of the posterior tibial nerve as it travels through the tarsal tunnel on the inner side of the ankle can cause pain, numbness, and tingling in the foot, including the heel and midfoot areas.
  • Overuse or Repetitive Strain Injuries: Activities that involve repetitive stress on the heel and foot, such as running or dancing, can lead to pain and inflammation in these areas.

Do Not Miss Diagnoses

  • Infection (e.g., Osteomyelitis, Cellulitis): Although less common, infections of the bone or soft tissue in the foot can cause severe pain and have serious consequences if not promptly treated.
  • Deep Vein Thrombosis (DVT): While DVT typically presents with swelling, redness, and warmth of the leg, it can occasionally cause foot pain and should be considered, especially in patients with risk factors for DVT.
  • Neoplastic Processes: Tumors, whether benign or malignant, can cause pain in the foot, including the heel and midfoot. Early detection is crucial for effective management.

Rare Diagnoses

  • Paget's Disease of Bone: A chronic condition that can result in enlarged and misshapen bones, leading to pain and deformity. It is rare but can affect the bones in the foot.
  • Sarcoidosis: A disease characterized by the growth of granulomas (inflammatory cells) in various parts of the body, including bones, which can cause pain and swelling in the affected areas, including the foot.
  • Gout or Pseudogout: Although these conditions more commonly affect the toes, they can occasionally cause pain in the heel and midfoot areas due to the deposition of urate crystals or calcium pyrophosphate dihydrate crystals, respectively.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.