Differential Diagnosis for Heel Pain with Radiation to the Leg and Burning Sensation in the Second Toe
- Single Most Likely Diagnosis
- Plantar fasciitis: This condition is characterized by pain in the center of the heel, often radiating to the leg, and can be associated with burning sensations in the toes due to referred pain or entrapment of nerves. The pain typically worsens with weight-bearing activities.
- Other Likely Diagnoses
- Tarsal tunnel syndrome: This involves compression of the posterior tibial nerve as it travels through the tarsal tunnel on the inner side of the ankle, leading to pain, numbness, and burning sensations in the foot, including the heel and toes.
- Peripheral neuropathy: Conditions such as diabetes can cause peripheral neuropathy, leading to burning sensations in the feet and toes, along with pain that can radiate from the heel.
- Achilles tendinitis: Although primarily causing pain at the back of the heel, severe cases can radiate pain down to the foot and potentially cause burning sensations due to nerve irritation.
- Do Not Miss Diagnoses
- Deep vein thrombosis (DVT): While less common, DVT can cause leg pain and swelling, and in rare cases, may present with heel pain if the clot affects blood flow to the lower extremities. Missing this diagnosis can be fatal if the clot dislodges and travels to the lungs (pulmonary embolism).
- Osteomyelitis or septic arthritis: Infections of the bone or joint can cause severe pain, including heel pain, and are medical emergencies requiring prompt treatment to prevent serious complications.
- Rare Diagnoses
- Entrapment of the first branch of the lateral plantar nerve (Baxter's nerve): This is a rare cause of heel pain that can radiate and cause burning sensations in the toes.
- Heel pad atrophy: A condition where the fat pad under the heel becomes thinner, leading to increased pressure on the heel bone and potential pain.
- Rheumatologic conditions (e.g., rheumatoid arthritis, gout): These can cause a wide range of symptoms, including heel pain and burning sensations in the toes, though they are less common causes of the specific symptom complex described.