What is the cause of right calcaneal (heel bone) pain?

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Last updated: April 12, 2025View editorial policy

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Differential Diagnosis for Right Calcaneus 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 and connects the heel bone to the toes. The pain is typically worse in the morning and after periods of rest.
  • Other Likely diagnoses
    • Calcaneal stress fracture: A small crack in the calcaneus bone, often caused by overuse or repetitive stress, leading to pain and discomfort in the heel area.
    • Achilles tendinitis: Inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, causing pain and stiffness in the back of the ankle and heel.
    • Heel spur: A bony growth on the underside of the heel bone, which can cause pain and discomfort when walking or standing.
    • Fat pad atrophy: Thinning of the fat pad under the heel, leading to reduced cushioning and increased pressure on the heel bone, resulting in pain.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
    • Osteomyelitis: A bone infection that can cause severe pain, redness, and swelling in the affected area, and can lead to serious complications if left untreated.
    • Tumor (e.g., osteoid osteoma): A rare type of bone tumor that can cause severe pain, often worse at night, and can be misdiagnosed as a more common condition.
    • Deep vein thrombosis (DVT): A blood clot in the deep veins of the leg, which can cause pain, swelling, and warmth in the affected area, and can lead to life-threatening complications if left untreated.
  • Rare diagnoses
    • Haglund's deformity: A bony growth on the back of the heel bone, which can cause pain and discomfort when walking or standing.
    • Retrocalcaneal bursitis: Inflammation of the bursa that separates the Achilles tendon from the heel bone, causing pain and swelling in the back of the ankle and heel.
    • Tarsal tunnel syndrome: Compression of the posterior tibial nerve as it passes through the tarsal tunnel, causing pain, numbness, and tingling in the foot and ankle.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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