Differential Diagnosis for Bilateral Foot Pain
Single Most Likely Diagnosis
- Plantar Fasciitis: This is the most common cause of bilateral foot pain, especially in the heel area. It is often associated with overuse, poor foot mechanics, or inadequate footwear, leading to inflammation of the plantar fascia.
Other Likely Diagnoses
- Morton's Neuroma: A common condition characterized by pain in the ball of the foot, typically between the third and fourth toes, due to compression or irritation of the nerve.
- Tarsal Tunnel Syndrome: Similar to carpal tunnel syndrome but affecting the foot, it involves compression of the posterior tibial nerve as it travels through the tarsal tunnel, leading to pain, numbness, and tingling.
- Overuse Injuries: Including stress fractures, shin splints, and Achilles tendonitis, which are common in individuals who have recently increased their physical activity or have poor training habits.
- Poorly Fitting Shoes: Can cause a variety of foot pains due to pressure points, lack of support, and altered gait mechanics.
Do Not Miss Diagnoses
- Diabetic Neuropathy: A serious complication of diabetes that can cause numbness, pain, and tingling in the feet. Early detection is crucial to prevent further complications.
- Peripheral Artery Disease (PAD): Characterized by poor circulation to the legs and feet, which can cause pain, especially during walking, and is a significant risk factor for heart attack and stroke.
- Infections: Such as cellulitis or abscesses, which can be serious and require prompt antibiotic treatment.
- Gout: A form of arthritis that can cause sudden, severe attacks of pain, swelling, redness, and tenderness, often in the big toe.
Rare Diagnoses
- Charcot-Marie-Tooth Disease: A group of inherited disorders that affect the peripheral nerves, leading to muscle weakness and atrophy, particularly in the feet and legs.
- Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, which can be primary or secondary to other conditions like myeloproliferative disorders.
- Complex Regional Pain Syndrome (CRPS): A chronic pain condition that most often affects one of the arms, legs, hands, or feet after an injury or trauma, characterized by intense burning or aching pain.