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Last updated: July 14, 2025View editorial policy

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Differential Diagnosis for Heel Pain

Single Most Likely Diagnosis

  • Plantar Fasciitis: This condition is the most common cause of heel pain, especially when it occurs with pressure and walking. It involves inflammation of the plantar fascia, a band of tissue that runs along the bottom of the foot, supporting the arch.

Other Likely Diagnoses

  • Achilles Tendinitis: Inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, can cause pain in the heel, especially with activity.
  • Heel Spur: A bony growth on the underside of the heel bone can cause pain when walking or pressing on the heel.
  • Fat Pad Atrophy: Thinning of the fat pad under the heel can lead to pain, especially with pressure and walking.
  • Overuse or Repetitive Strain: Activities that involve repetitive running, jumping, or walking can lead to heel pain due to overuse.

Do Not Miss Diagnoses

  • Infection (e.g., Osteomyelitis or Septic Arthritis): Although less common, infections in the bone or joint of the heel can be serious and require prompt treatment.
  • Tumor: Both benign and malignant tumors can occur in the heel, and while rare, they are critical to diagnose early.
  • Fracture: A stress fracture or other types of fractures in the heel can cause pain, especially with weight-bearing activities.

Rare Diagnoses

  • Rheumatologic Conditions (e.g., Rheumatoid Arthritis, Psoriatic Arthritis): These conditions can cause heel pain among other symptoms, but are less common causes compared to the above diagnoses.
  • Nerve Entrapment (e.g., Tarsal Tunnel Syndrome): Compression of nerves in the foot can lead to pain, numbness, and other symptoms in the heel and foot.
  • Bursitis: Inflammation of the bursae (fluid-filled sacs) near the heel can cause pain and swelling.

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.

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