Differential Diagnosis for Heel Pain Worse with Sitting
- Single most likely diagnosis
- Plantar fasciitis: This condition is the most common cause of heel pain and can be exacerbated by sitting due to increased tension on the plantar fascia when standing up after a period of rest.
- Other Likely diagnoses
- Achilles tendinitis: Inflammation of the Achilles tendon can cause heel pain that worsens with activity, including standing after sitting.
- Heel spur: A bony growth on the underside of the heel bone can cause pain when walking or standing, especially after sitting.
- Fat pad atrophy: Thinning of the fat pad under the heel can lead to increased pressure on the heel bone, causing pain that may worsen with sitting.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Osteomyelitis: A bone infection in the heel can cause severe pain, especially with weight-bearing activities, and is a medical emergency if not promptly treated.
- Tumor (e.g., osteoid osteoma): Although rare, a tumor in the heel can cause persistent pain that worsens with activity and sitting.
- Deep vein thrombosis (DVT): While less common in the heel, DVT can cause pain and swelling in the leg, including the heel area, and is a life-threatening condition if not treated promptly.
- Rare diagnoses
- Haglund's deformity: A bony enlargement at the back of the heel bone can cause pain and inflammation, especially with certain types of shoes.
- Retrocalcaneal bursitis: Inflammation of the bursa between the Achilles tendon and the heel bone can cause pain and swelling in the heel area.
- Nerve entrapment (e.g., Baxter's nerve): Compression of the nerve that runs under the heel can cause pain and numbness in the heel area.