Differential Diagnosis for Heel Pain with Flexing
- Single most likely diagnosis
- Plantar fasciitis: This condition is the most common cause of heel pain and is often exacerbated by flexing the foot, which stretches the plantar fascia. The pain is typically sharp and stabbing, and it usually occurs with the first steps in the morning or after periods of rest.
- Other Likely diagnoses
- Achilles tendinitis: Inflammation of the Achilles tendon can cause pain in the heel, especially when flexing the foot. This condition is common in runners and athletes who participate in sports that involve repetitive ankle movements.
- Heel spur: A heel spur is a bony growth that can develop on the underside of the heel bone, causing pain when the foot is flexed. Heel spurs are often associated with plantar fasciitis.
- Fat pad atrophy: The fat pad under the heel can become thinner and less cushioned with age, leading to pain when the heel is flexed.
- Do Not Miss diagnoses
- Calcaneal stress fracture: A stress fracture in the heel bone can cause severe pain, especially with weight-bearing activities and flexing of the foot. This condition requires prompt medical attention to prevent further complications.
- Infection (e.g., osteomyelitis or septic arthritis): Infections in the heel or ankle can cause severe pain, redness, and swelling. These conditions are medical emergencies that require immediate attention.
- Tumor (e.g., osteoid osteoma): Although rare, a tumor in the heel can cause persistent pain that worsens with activity and flexing of the foot.
- Rare diagnoses
- Haglund's deformity: A bony growth on the back of the heel bone can cause pain and inflammation, especially when the foot is flexed.
- Bursitis: Inflammation of the bursae (fluid-filled sacs) in the heel can cause pain and swelling, especially with flexing of the foot.
- Nerve entrapment (e.g., tarsal tunnel syndrome): Compression of the nerves in the foot can cause pain, numbness, and tingling, especially with flexing of the foot.