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 supports the arch 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 can cause pain when walking or standing.
- Bursitis: Inflammation of the fluid-filled sacs (bursae) that cushion the heel bone can cause pain and swelling.
- Fat pad atrophy: Thinning of the fat pad under the heel can lead to pain and discomfort.
- 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, requiring prompt antibiotic treatment.
- Tumor: Although rare, a tumor in the heel can cause persistent pain and should be ruled out with imaging studies.
- Fracture: A stress fracture or other type of fracture in the heel bone can cause severe pain and require immobilization.
- Rare diagnoses
- Rheumatoid arthritis: Although more commonly associated with other joints, rheumatoid arthritis can cause heel pain and swelling.
- Gout: A type of arthritis that can cause sudden, severe pain and swelling in the heel.
- Nerve entrapment: Compression of the nerves in the heel can cause pain, numbness, and tingling.
- Infection: Cellulitis or abscess in the heel can cause pain, redness, and swelling, requiring prompt antibiotic treatment.