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Diagnosis and Management of Heel Pain

Rosaline Helgeson

Although there are many potential causes of heel pain, mechanical causes are most frequently identified. The diagnosis may be aided by knowing the precise anatomical site of the discomfort. The most typical diagnosis is plantar fasciitis, which causes pain in the medial plantar heel, particularly with the initial weight-bearing steps following rest. The following conditions can also result in plantar heel pain: heel pad syndrome, which causes a deep, bruising-like pain in the middle of the heel; calcaneal stress fractures, which cause pain that gets worse over time after increasing activity or switching to a harder walking surface; nerve entrapment or neuromas; and plantar warts. Posterior heel discomfort is frequently brought on by achilles tendinopathy, although pain from other tendinopathies is restricted to the area where the afflicted tendon inserts. Haglund deformity, a protrusion of the calcaneus that may cause retrocalcaneal bursa inflammation, and Sever disease, a prevalent form of calcaneal apophysitis in children and adolescents, are other potential causes of posterior heel discomfort. Tarsal tunnel syndrome, which is brought on by compression of the posterior tibial nerve, may be the cause of medial midfoot heel pain, especially with extended weight bearing.