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 Diagnoses
- Calcaneal fracture: A break in the heel bone, which can be caused by a fall from a height or a sudden impact. Missing this diagnosis could lead to improper healing and chronic pain.
- Osteomyelitis: A bone infection that can cause severe pain and requires prompt antibiotic treatment to prevent serious complications.
- Tumor: Although rare, tumors such as osteoid osteoma or Ewing's sarcoma can cause heel pain and must be considered to ensure timely diagnosis and treatment.
- Rare Diagnoses
- Rheumatoid arthritis: An autoimmune disorder that can cause inflammation and pain in the heel, among other joints.
- Gout: A form of arthritis characterized by sudden, severe attacks of pain, swelling, redness, and tenderness, which can occur in the heel.
- Paget's disease: A condition that affects bone remodeling, leading to weakened bones and potential pain, including in the heel.
- Entrapment of the posterior tibial nerve or the first branch of the lateral plantar nerve: Compression of these nerves can cause heel pain and must be considered in the differential diagnosis.