Differential Diagnosis for "Hurts to Walk"

Single Most Likely Diagnosis

• Plantar Fasciitis: This condition is characterized by inflammation of the plantar fascia, leading to pain in the heel and bottom of the foot, especially with the first steps in the morning or after periods of inactivity. It's a common cause of heel pain and can significantly affect walking.

Other Likely Diagnoses

• Osteoarthritis: Wear and tear on the joints can cause pain while walking, especially in weight-bearing joints like the hips, knees, and ankles.
• Tendinitis: Inflammation of the tendons, which connect muscles to bones, can cause pain, especially if the affected tendons are in the feet, ankles, or legs.
• Bunions: A bony bump at the base of the big toe can cause pain and discomfort while walking due to pressure and friction.
• Morton's Neuroma: A condition where a nerve in the foot becomes irritated or compressed, leading to pain between the toes and potentially affecting gait.

Do Not Miss Diagnoses

• Deep Vein Thrombosis (DVT): Although less common, DVT can cause leg pain or swelling that worsens with walking. It's crucial to diagnose promptly due to the risk of pulmonary embolism.
• Peripheral Artery Disease (PAD): This condition involves narrowing of the arteries, which can lead to intermittent claudication (pain in the legs or buttocks during exercise, such as walking).
• Osteonecrosis (Avascular Necrosis): The loss of blood to the bones can cause pain, especially in the hips, which worsens with walking. Early diagnosis is critical to prevent collapse of the bone.
• Infections (e.g., Osteomyelitis, Septic Arthritis): Infections of the bone or joints can cause severe pain, especially with movement, and require urgent medical attention.

Rare Diagnoses

• Charcot-Marie-Tooth Disease: A group of inherited disorders that affect the peripheral nerves, leading to muscle weakness and atrophy, which can cause gait disturbances and pain.
• Ehlers-Danlos Syndrome: A group of disorders that affect connective tissues supporting the skin, bones, blood vessels, and many other organs and tissues, which can lead to joint hypermobility and pain.
• Complex Regional Pain Syndrome (CRPS): A chronic pain condition characterized by severe, burning pain at the site of an injury, which can be exacerbated by walking.

Each of these diagnoses has a different set of symptoms and risk factors, and a thorough medical history, physical examination, and sometimes additional tests are necessary to determine the underlying cause of the pain.