Differential Diagnosis for Heel Pain
- Single most likely diagnosis
- Plantar fasciitis: This is the most common cause of heel pain, resulting from inflammation of the plantar fascia, a band of tissue that runs along the bottom of the foot. It is often associated with overuse, poor foot mechanics, or inadequate footwear.
- Other Likely diagnoses
- Achilles tendinitis: Inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, can cause heel pain, especially with activities that involve running or jumping.
- Heel spur: A bony growth on the underside of the heel bone, which can cause pain when walking or standing.
- Bursitis: Inflammation of the fluid-filled sacs (bursae) that cushion the joints and reduce friction between bone and soft tissue can lead to heel pain.
- Fat pad atrophy: Thinning of the fat pad under the heel can cause pain, especially in older adults.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Osteomyelitis: A bone infection that can cause severe heel pain, redness, and swelling. It requires prompt antibiotic treatment to prevent serious complications.
- Tumor: Although rare, a tumor in the heel can cause persistent pain and should be considered in the differential diagnosis to ensure timely treatment.
- Fracture: A stress fracture or other type of fracture in the heel can cause severe pain and requires proper diagnosis and treatment to prevent further complications.
- Rare diagnoses
- Rheumatoid arthritis: Although more commonly associated with other joints, rheumatoid arthritis can cause heel pain due to inflammation of the joints in the foot.
- Gout: A form of arthritis characterized by sudden, severe attacks of pain, swelling, redness, and tenderness, which can occur in the heel.
- Nerve entrapment: Compression or irritation of the nerves in the foot can cause heel pain, numbness, or tingling.